I am beginning to change my mind regarding claim review for HSAs. On a macro level the idea of HSAs was to put the consumer in the driver’s seat, and the consumer to control the funds being paid out for health care. That is foundation idea of consumerism or consumer driven plans. Employees must feel the pain of paying for first dollar coverage. I agree that on a macro level this approach has merits, but requires a change in behavior. All signs (wellness, growth of HSAs etc) point to the idea it may be working. I don’t want to stand in the way of this progress.
As a TPA that administers claims for HRAs, FSAs, Transit plans we would benefit from the law requiring claim review, thus my previous comments could be viewed as self serving. However, we see the day-to-day abuses of Flex and HRA plans as well as debit cards. This country was founded on the idea of being independent, non-conformist, and Americans are notorious for not wanting to pay taxes or follow rules. And that is why Congress through the tax simplification act of 1986, eliminated collecting “shoe boxes full of receipts” for medical expenses, and claiming them on long form taxes because of widespread abuses. This law began the market need for cafeteria plans.
We see the same abuses in HSAs, and as we travel the country speaking on topics that deal with HSAs, we hear more abuses of HSA dollars than ever before. Why? Because employees don’t like to get educated, it is viewed as THEIR money, and a central place doesn’t exist to find claim information. Calling your bank where the HSA is at and Tellers typically aren’t equipped to answer claim questions. So abuses continue, and will increase hence the idea that lack of claim review could be the Achilles heel for HSAs. Thus claim adjudication could assist in the longevity of HSAs.
On a micro level eflex and TPAs will benefit from claim review, but on the macro level the consumer will not. And ultimately we are here to serve the consumer. The consumer will not benefit because of the increased costs associated with claim review. The bank charges for holding the account, and providing services. A TPA will charge for the review. The monthly cost could be in the $4-$8 range which may prevent both the employer and employee from purchasing an HSA.
Our higher calling is to support the consumer.
Is claim review a good idea? That will be your decision. Contact your representative today, and let your voice be heard.
For more reading on the bill: http://www.govtrack.us/congress/billtext.xpd?bill=h110-5719
Contact your Congressional Representative and Senators: http://www.usa.gov/Contact/Elected.shtml