Key takeaways:
-
Intermountain Health grew high-deductible health plan (HDHP) enrollment from just 6% in 2010 to 80% by addressing employee barriers, misconceptions, and fear of starting the year with a $0 balance.
-
Front-loading employer Health Savings Account (HSA) contributions on day one was the turning point: once employees knew funds were available immediately, enrollment surged.
-
The result was $10.5 million in annual employer healthcare savings, proving that employee-centered plan design isn't just good for people; it's good for the bottom line.
The term “high-deductible health plan” can be intimidating for employees. It might bring to mind high out-of-pocket costs, making it a tough sell for benefits teams. But what if you could change that perception and empower your employees to build a financial safety net?
Intermountain Health, a Salt Lake City-based healthcare system with over 63,000 employees, faced this exact challenge. Dave Adams, VP of Executive Compensation and Benefits at Intermountain Health, understood the potential of HSAs and qualified plans to provide effective, affordable healthcare and help establish a financial safety net for employees.
Why are employees hesitating to enroll in HDHPs?
Like many employers, Intermountain Health struggled with low enrollment in their HDHP and HSA offering. They introduced the benefit in 2006, but by 2010, only 6% of their eligible workforce had opted in, leaving $31 million in potential premium savings on the table.1
Through employee feedback, they identified several key barriers:
- Confusion between HSAs and FSAs
- Employee misconceptions about HDHPs
- Employee fear of starting the plan year with $0 in their HSA
The benefits team listened to employee feedback and addressed each barrier with targeted solutions such as financial incentives, structural plan changes, and a commitment to overcoming concerns.
They started in 2010 with an HSA match ($300 single/$600 family), then more than doubled it the following year ($750 single/$1500 family) to make the benefit more appealing.
Contribution timeline that led to the breakthrough:
2010: Intermountain introduced an HSA match ($300 single/$600 family).
2011: They more than doubled the match ($750 single/$1,500 family) to increase perceived value.
2012: They solved the “zero-balance” concern by partnering with HealthEquity to front-load 50% of the employer HSA contribution, so funds were available on day one of the plan year.
Result: Enrollment climbed to 33% because employees felt more confident about early-year expenses.
How can employers accelerate HSA adoption?
Building on their initial success, Intermountain Health’s benefits team refined their approach. In 2017, they introduced an additional HDHP with an even more powerful incentive: Any new employee who selected the HealthSave medical plan for the first time would be eligible for 100% of the full employer contribution on the first pay period if they made even a single contribution of any amount into their HSA. This demonstrated a deep commitment to the financial security of their employees, and enrollment soared to 67%. This and additional targeted support for lower-income employees propelled enrollment to an incredible 80%.2
“A lot of people will say that HSAs are more beneficial for higher-paid employees, but I don’t think that’s true. We want everyone to be able to save for health expenses while they’re employed or even in retirement.”
Dave Adams, VP Executive Compensation and Benefits, Intermountain Health
Intermountain Health’s thoughtful, multi-year strategy has paid off, driving enrollment far beyond industry benchmarks. By listening to feedback, offering powerful incentives, and removing financial barriers, they empowered caregivers to take control of their health and future—resulting in impressive, measurable results.
As of today: results at a glance
| Metric | Intermountain Health outcome |
|---|---|
| HSA members contributing | 99% |
| Average employee contribution | $2,900 annually |
| Average HSA balance | $5,600 |
| Benchmark callout | More than double the industry median (for average employee contribution) |
The impact on employees has been profound. One Intermountain caregiver shared, “For the first time in my life, I am now able to afford to take [my family] to the doctor or the hospital because I have saved enough money in my HSA. This peace of mind is priceless for me.”3
What did Intermountain Health do to build a culture of HSA savings?
Intermountain Health’s journey proves that with a thoughtful, employee-centered strategy, employers can overcome common barriers to HSA adoption. Matching employee contributions, making funds available on day 1, and educating employees on their savings options can help build confidence and drive participation.
Quick action checklist you can apply
Intermountain Health’s approach shows what can work when you make HSAs easier to start and easier to understand:
-
Match employee contributions to encourage early participation.
-
Make funds available on day one to reduce fear of early-year expenses.
-
Incentivize employee enrollment in HDHPs with tiered contributions and a solid benefits education program.
Learn more about how Intermountain Health’s success story by reading the full case study here.
Frequently Asked Questions
References and disclosures
1 Intermountain Health PEPMM health plan cost data.
2 Results may vary by employer.
3 Individual results may vary. Past performance does not guarantee future results.
HealthEquity does not provide legal, tax, or financial advice.
