Health Savings Accounts Worth the Investment

Got the sniffles?

Many of us do these days. Might as well go to the doctor and get it checked out. And, in many cases, for a mere $10 co-payment, why not?

Well, President Bush would prefer you consider an over-the-counter medicine first.

That's why he introduced Health Savings Accounts at the end of 2003. He was hoping that these glorified IRA accounts would do two things: Help people be more conscientious of their medical expenses and allow them to save money for health care in their old age. (Takes the pressure off having to deal with the Medicare/Medicaid issue, I guess.)

What's not to like about HSAs? Contributions are deductible, the account accumulates tax-free, and withdrawals used for medical expenses are tax-free. The president's practically giving away money.

Nevertheless, hardly anyone was using them in 2004. Prior to Jan. 1, 2005, Aetna (AET ) had a mere 10 companies with 51 or more employees signed up, according to Robin Downey, head of product development at Aetna.

Part of the reason was timing. "These accounts were authorized in December 2003 -- too late for many companies to get their benefit packages together. Most do that in the fall or late summer," says Mark Luscombe, principal federal tax analyst with CCH Inc., a provider of tax and business law information.

The other culprit was the unfinished rulebook. "The Treasury didn't finish guidance in time," notes Downey. In other words, no one fully understood the rules.

But even with the rules ironed out, the numbers still aren't staggering. Aetna now has 70 companies with 51 or more employees signed on and Cigna(CI ) has around 30, according to Jake Biscoglia, an assistant vice president at Cigna.

But both insurers say there is definitely more chatter among their clients about offering these products in the future, so you may start to see HSAs the next time your benefits department has open enrollment.