Do your clients have health savings accounts? If you can't answer that question or if you aren't interested enough to concern yourself with HSAs, then you and your clients are missing an opportunity and an investment advantage.
Since 2003 when President Bush signed them into law, HSAs have been touted as the 401(k)s or individual retirement accounts with a health twist. Tax-deferred, these accounts are consumer-driven health plans, which promise to help employers control health-care costs by placing some health-care responsibility and accountability with employees.
Last year, there were 1.9 million HSAs, according to an estimate from Celent Communications LLC of Boston, a financial research firm.
In 2008, Celent expects HSAs to number around 3 million. The growth comes after a 36% increase in 2006 and a 60% increase last year.
The number of accounts and investment opportunities will in-crease as health-care costs rise and the government continues to develop strategies for increased health care coverage, and as consumers shoulder more of the responsibility and rewards for their own health care. By 2012, HSAs could number 20 million, with more than $200 billion in assets.
Despite the myth that HSAs cater to the healthy and the wealthy, HSAs are widespread in use, cutting across the demographics of age, income, and portfolio size.
HSAs are available to any individual who is covered by a high-deductible health care plan, who isn't covered by any other insurance, and who hasn't tapped into Medicare. There are no income limits, earned or not, that restrict who contributes to HSAs, and both employers and individuals can feed the accounts.
In 2008, contribution levels were $2,900 for an individual and $5,800 for a family in pre-tax dollars. Also, individuals age 55 and older can also make catch-up contributions of an additional $900 and $1,000 this year and next.
The funds grow tax-deferred, and as long as they are withdrawn for qualified medical expenses, there is no tax liability. There is no requirement to spend down account balances as there is for some retirement plans and IRAs.
Also, individuals can make a one-time transfer from their IRA to an HSA, subject to the annual contribution limits.
So what does this mean for your clients?
HSAs are more than a mere insurance policy or a savings account for health expenses. They are a long-term investment vehicle for retirement planning, and they should be part of the big-picture strategy.
In fact, many account holders even choose to guard their HSA funds and pay for health expenses out-of-pocket to protect the tax-free growth of their accounts.
It is time for HSAs to be brought under the umbrella of the client's investment portfolio, rather than living in isolation. Clients need guidance on how to direct and manage those funds, just as they seek advice on how to groom other assets.
And what does this mean for the investment adviser? HSAs change the relationship.
First, advisers will need to understand what sort of HSAs your existing custodians offer, or if it is necessary, to find other financial relationships to determine the costs and structure of the product, and how it fits into the financial picture of the client.
After that, you will need to understand health insurance.
With HSAs, you inherit a whole new set of investments and possibly a lot of questions about health:
Should clients pay for their medical expenses from the account, or save the money for future use? Should your clients opt for a $5,000 or a $3,000 deductible? Should they roll IRA funds into an HSA this year?
How much should they save for health care needs in retirement? What other health care strategies, such as medical, long-term care, supplemental health insurance and health management do they need to line up?
Health care has become an issue for financial planning, and it is becoming a central issue for retirement planning. In fact, one of the top reasons people withdraw money early from 401(k)s is to cover medical bills.
To rewrite its impact in numbers, if you were calculating a person's average monthly cost in health insurance at retirement in the hundreds of dollars, you instead should start calculating it at a few thousand dollars, according to the Minneapolis-based Devenir Group LLC, which develops HSA investment platforms.
Health care, not just HSAs, needs to be part of the investment strategy and ongoing discussion.
Dennis Triplett is the president of health services for UMB Bank in Kansas City, Mo.
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