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U.S. Master™ Pension Guide, 2009 Edition
Revised for 2009 to include relevant provisions of the Heroes Earnings Assistance Relief Tax (HEART) Act and the Emergency Economic Stabilization Act.

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CCH® BENEFITS — 12/7/07

Most HSAs Provide First-Dollar Coverage For Preventive Care

From Spencer's Benefits Reports: The great majority of high-deductible health plans (HDHPs) that are compatible with health savings accounts (HSAs) covered recommended preventive care services before the deductible (first-dollar coverage), according to recently released research by America’s Health Insurance Plans (AHIP). The survey, A Survey of Preventive Benefits in Health Savings Account (HSA) Plans, July 2007, also revealed that more than half of those plans (52%) did not place an annual dollar limit on the preventive care coverage, and fewer than one-fourth limit it to $500. The survey garnered responses from 36 insurers with more than 1.7 million HDHP/HSA enrollees as of July 2007. Three-fourths of the policies did not require any cost sharing for preventive services.

Generally, an HDHP cannot provide benefits before the deductible is satisfied, but there is a statutory exception for benefits for preventive care.

More than four-fifths (84%) of the HDHP/HSA policies bought in group and individual markets as of July 2007 provided first-dollar coverage for recommended preventive care services. As might be expected, this coverage was much more prevalent among group policies than among individual policies—99% of large group plans, 96% of small group plans, but only 59% of individual plans offered such coverage.

All plans covering preventive services included immunizations, well-baby care, well-child care, mammograms and PAP tests, and annual physicals (including adult blood pressure checks and cholesterol tests); nearly 90% of plans included prostate cancer screenings, while more than 80% cover colonoscopies. Other screenings covered in annual physicals were child vision tests, bone mineral density tests for women, colon cancer screenings, prostate cancer screenings for men age 50 and older, and adult screenings for depression and substance abuse.

Fewer than 6% of the HDHP/HSA policies included in the survey covered some prescription drugs as preventive care, due to Internal Revenue Service guidance that prohibits such treatment for drugs used for care of a medical condition, AHIP remarked. Group policies for groups of at least 3,000 employees were most likely (27%) to cover as preventive benefits prescription drugs for prevention of asthma, diabetes, heart disease, stroke, and seizures.

In January 2007, AHIP reported a total of 4.5 million HDHP/HSA enrollees with an average enrollment among all respondents of 48,300 and a median of 10,200. The three largest insurers reported enrollment between 200,000 and 300,000. For more information, visit http://www.ahip.org.

For more information on this and related topics, consult the CCH Pension Plan Guide, CCH Employee Benefits Management, and Spencer's Benefits Reports.

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