Consumer-directed health care and case management: Part 2

Abstract

Previously, we reviewed the three basic plan designs in consumer-directed health care (CDH): • Health savings accounts (HSAs): Consumer-owned bank accounts that provide tax benefits on funds contributed by individuals and/or employers. Once contributed, the money in this account is owned by the consumer and is fully portable, with no rollover caps from year to year on unused funds. These accounts may cover prevention for each enrolled member. • Health reimbursement arrangements (HRAs): employer funds made available to cover an employee's qualified expenses through a carrier. HRAs allow 100% prevention coverage to each enrolled member and permit money to be rolled over from year to year, with rollover caps as desired by the employer and health plan. HRAs are not portable, but the law does permit access to the funds beyond employment, as long as the funds reside with the employer. • Flexible spending accounts (FSAs): funds deducted tax-free from employee salaries to cover specific expenses. These are “use it or lose it funds” that expire at the end of the year.