Just 13% of the 1,100 respondents to WEX Health’s first-ever Clear Insights report identified a health savings account (HSA) as the employer benefit that provides the most pre-tax savings.

In addition, more than half (54%) were not aware that they could invest their HSA funds in stocks, mutual funds and other investment vehicles. And, three-quarters of respondents see their HSA as a way to pay for health care expenses this year, which indicates they may not be aware that funds can be carried over into the next year. WEX Health says all these findings add up to a significant opportunity for further education on the triple-tax advantages of HSA accounts.

More than three-quarters (82%) of those who participate in high deductible health plans (HDHPs) either somewhat or strongly agree that managing their health care spending account helps them make smarter health decisions. The survey found the ways to motivate employees the most to access resources and make better health care choices are financial incentives (64%), emails (43%), online tools and resources (38%) and online ability to track employees’ health care goals (33%).

The most challenging part respondents cited in using their HSA was making sure to have enough funds set aside to cover deductibles (29%) and figuring out how much money to put in the account overall (21%).

Almost three-quarters (74%) of respondents enrolled in HDHPs say they consider reduced monthly premiums when evaluating their health plan options. Then, the primary reason these respondents enrolled in HSAs in addition to their HDHP was to save for future health care needs (36%) and to have an ability to save for out-of-pocket and/or unexpected medical costs (29%).

Nearly two-thirds of those surveyed are somewhat or very worried about unexpected out-of-pocket costs of current health care needs or illnesses, and of those people, nearly half are also worried about the cost of health care in retirement. One-quarter of respondents say they forgo health care services all the time or often due to associated out-of-pocket expenses.

When asked to select all the tools and resources they would find most helpful in selecting a health plan, respondents ranked highest the tools that compare plans, estimate costs, and calculate savings (61%). Fact sheets (51%) were selected as the most useful of educational resources. In-person presentations during which employees can get immediate answers from human resources and benefits administration representatives ranked high (38%), with more passive videos (15%) and webinars (14%) ranking lower.

Suggested employer actions

Seeing breakdowns of plan enrollment and spending by plan and expense types can be very useful to Human resources (HR), payroll and finance managers, WEX Health says. Seeing comparisons to these enrollment and spending breakdowns in similar employer groups reveals considerations for future plan design and areas where additional education might be needed. For example, the firm says, if an employer group notices its employees have contributions far below the average for certain plan types, it might want to dig deeper to understand why. Perhaps education is needed about the benefits of each available plan type, and what types of expenses are eligible.

“Since employers can play such a key role in educating and helping employees make good choices for their physical and financial well-being, it is vital that they understand employees’ engagement levels,” the report says. A measure of an employee population’s interaction with tools available to them can help employers develop robust engagement strategies beginning with open enrollment education and continuing with personalized, event-based notifications, email reminders, and other mechanisms.

WEX Health also suggests personalizing the employee website for different employee populations or individual users and creating a customized resource library of educational material and tools.