HSA Industry Reaches $116 Billion in Assets

Aided by positive stock market gains, Health Savings Accounts assets saw strong growth in the first half of 2023, while increase in the total number distinct HSA accounts has slowed, according to new data from Devenir Group LLC. 

At the midyear point of 2023, Devenir reported $116 billion in HSA assets held in almost 36 million accounts, a year-over-year increase of 17% for assets and 6% for accounts.  

The number of accounts jumped from 33.9 million to 35.5 million during the last half of 2022. This differs from the much smaller increase in accounts between the end of 2022 to the first half of 2023 (from 35.5 million to 35.9 million).  

The Devenir survey was carried out in the summer of 2023, with data requested for the period ending on June 30.  

An HSA allows a participant who is enrolled in a high deductible health plan to set aside money on a pre-tax basis to pay for qualified medical expenses. The untaxed funds can be used to pay for deductibles, copayments, coinsurance and some other expenses.  

Almost 2.7 million HSAs, representing more than 7% of accounts, have at least a portion of their HSA dollars invested. 

“We continue to see seasonality in the percentage of accounts that are unfunded,” the Devenir report stated. “Accounts are often opened during the fall open-enrollment season, but remain unfunded until early the following year. Halfway through 2023, about 18% of all accounts were unfunded, down from 19% a year ago.” 

HSAs opened in the first half of 2023 had an average of $1,143 at the mid-year point, compared to a $1,464 average balance at the mid-year point of 2022. Devenir attributed this higher balance in 2022 to more mergers and acquisitions, as well as account transfers from existing accounts as new accounts. In the first half of 2023, there has been less M&A activity that would result in that new balance being higher. 

On the positive side, Devenir saw strong contribution and withdrawal activity in 2023. Account holders contributed $29 billion to their accounts in the first half of 2023 (up 11% from the year prior) and withdrew $21 billion from their accounts during the first half of 2023 (up 16% from the year prior). 

After analyzing the top 100 providers in the HSA market, Devenir found that 31% of all HSA dollars contributed to an account came from an employer, with an average employer contribution of $726 in 2023. 

On the participant side, around 57% of all HSA dollars contributed to an account came from an employee. The average employee contribution this year was $1,327.  

The remaining 11% of all HSA dollars came from individual accounts not associated with an employer, with an average individual contribution of $1,957. Other contributions came from individual retirement account rollovers and other sources. 

Improving Understanding of HSAs 

While HSAs are viewed as a useful tool for employers seeking new ways to help their employees shoulder health care expenses, a recent Goldman Sachs Ayco report found that not all employees know how to use these accounts.  

According to a 2020 survey, 40% of employees reported feeling less than confident in understanding their HSA. 

Goldman’s 2023 Benefit and Compensation Trends report showed that almost 5% of companies increased their contributions to employee HSAs as a way to offset increases to health insurance premiums. In addition, the companies surveyed are allocating more resources to educate employees on HSA fundamentals and benefits, including the triple tax advantage. Money saved to an HSA is not taxed when it is deposited or spent, or on any capital gains. 

Goldman advisers also focus on HSAs with many clients during open enrollment season, according to the report. 

In addition, almost 25% of Goldman’s corporate partners include a company match and/or additional dollars for completing certain wellness activities and health screenings, rather than just a fixed company HSA contribution.  

Some companies even allow employees to convert their unused paid time off into HSA contributions, according to Goldman. 

Looking Ahead 

HSA providers project that assets will grow 15% by the end of 2023, while anticipating that their own business will grow by 23% during the same period.  

However, as a greater share of HSA assets are held in investments, market movement will make forward-looking projections more difficult, according to Devenir. The firm currently predicts that the HSA market will exceed 40 million accounts by the end of 2025, holding more than $150 billion in assets. 

In related HSA news, Conduent Inc. announced this week that it will transfer all of its health savings account assets to HealthEquity Inc., a fintech company that serves as a non-bank health savings trustee. The firms entered into an agreement to transfer $2.7 billion in HSA assets held by approximately 665,000 customers in Conduent’s BenefitWallet platform to HealthEquity for a projected purchase price of about $425 million.