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HSAs: What About the Fees?

Philip Betbeze, for HealthLeaders Media, July 18, 2014

Say I average $500 in my HSA for the year. They're going to charge me $2.50x12=$30 for the year. That amounts to 6% annually in fees for taking no risk. Even if I had the required $2,000 cash minimum for investing in further products beyond a savings account, it's 1.5% a year just to hold my money for me. Never mind that they get to hold and use my money while I'm waiting to incur a healthcare bill. Multiply that by the thousands of HSAs that are being established nationwide—enrollment reached 15.5 million last year, according to the trade group America's Health Insurance Plans—and you can see it's a very lucrative business line. It's a pretty sweet deal for the bankers, but not the account holders. If anyone ever offers you 6% a year with no risk, you should either jump at the chance or suspect you're looking at the next Bernie Madoff. It'll never happen to you, but it does to the banks.

So what's the message to hospital leadership about these accounts? Why should you care?

First of all, you're likely one of your city's or region's largest employers. You may offer HSAs and high-deductible insurance plans to your employees already. And you're in the best position to see the possible long-term effect from a high fee and money management structure that eats significantly into your employees' and your customers' ability to pay for healthcare services over time.

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