Top Tips for Small-Business Owners Implementing a High-Deductible Health Plan with an HSA 

by Heather Harte

Over the years, we have seen that many business owners have similar challenges in understanding Health Savings Account (HSA) funding, plan design and contribution strategies. As HSA use continues to grow, there are no shortage of questions that will need to be answered. We’ve outlined four tips for effectively designing a high-deductible health plan (HDHP) with an HSA.

A well-designed plan is one that drives higher enrollment — resulting in higher savings for the business owner. This is done all while improving employee health and well-being by helping employees become smarter, more deeply engaged healthcare consumers.

We recommend considering the following tips to maximize the benefits of offering an HDHP with an HSA:

Allow pre-tax employee contributions. Employees get the current tax savings on their HSA contributions, as opposed to waiting for tax returns, while also enjoying the convenience of payroll deductions to contribute to their accounts. Simultaneously, employers save on payroll taxes and expenses due to paying them on a lower gross income.

Note: This requires the HSA to be structured within a Section 125 Cafeteria Plan

  1. Make contributions to employee accounts. An employer’s contribution is the single most effective way to get employees to save. The amount should be significant enough to grab attention and interest. We recommend contributing earlier in the year to help alleviate a common barrier, which is the fear of an unexpected healthcare expense with no funds available to cover it.
  2. Price the plan attractively. In general, we recommend that the HDHP be priced very competitively — if not the lowest monthly premium option. We say this because, for those employees who carefully budget, a low premium is a known expense that helps overcome some of the concerns associated with the higher deductible.
  3. Pay accountholder fees for employees. Our final recommendation is to pay accountholder fees for employees. This may seem like a small thing considering the average monthly fee for an accountholder is only a few dollars, but paying these fees makes a significant difference in employees’ perception of the value of the plan.

Keep these items in mind as you look at implementing or improving your HSA offering. Educating and supporting employees is key to driving enrollment and realizing the financial benefit of implementing an HDHP with an HSA.

More information at

Heather Harte is Western Region VP Healthcare Services of UMB Bank

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