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Employee Benefits
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High deductible health plans and health savings accounts
This factsheet highlights High Deductible Health Plans (HDHP) and Health Savings Accounts (HSA) estimates for private industry workers from the National Compensation Survey (NCS)(1).
The availability of HDHPs for private industry workers participating in medical care plans was 38 percent in 2015 and 50 percent in 2024. Among the private goods-producing industry, access to HDHP plans was 37 percent in 2015 and 46 percent in 2024. For the service-providing industry, access to HDHP plans was 38 percent in 2015 and 51 percent in 2024. (See chart 1.)
| Worker characteristic | 2015 | 2024 |
|---|---|---|
|
All workers |
38% | 50% |
|
Goods-producing industry |
37% | 46% |
|
Service-providing industry |
38% | 51% |
|
Source: U.S. Bureau of Labor Statistics, National Compensation Survey |
||
HDHPs typically have higher deductibles and lower premiums than traditional (non-high deductible) health plans. In 2024, the median annual deductible for private industry workers participating in HDHP plans was $2,750. (See chart 2.)
| Plan | 10th percentile | 25th percentile | 50th percentile (median) | 75th percentile | 90th percentile |
|---|---|---|---|---|---|
|
High deductible |
$1,700 | $2,000 | $2,750 | $3,200 | $5,000 |
|
Source: U.S. Bureau of Labor Statistics, National Compensation Survey |
|||||
HDHPs allow workers to establish Health Savings Accounts (HSA), which are employee-owned and used to pay for medical expenses with pretax contributions. Additionally, HSAs may earn tax-free interest and unused contributions roll over from year to year.
Access to HSAs increased from 24 percent in March 2015 to 39 percent in March 2024 for private industry workers. In March 2015, 15 percent of workers in establishments with less than 100 workers had access to HSAs, increasing to 27 percent in March 2024. The percentage of workers with access to HSAs in establishments of 500 workers or more was 36 percent in March 2015 and 58 percent in March 2024. (See chart 3.)
| Year | All workers | Less than 100 workers | 100-499 workers | 500 workers or more |
|---|---|---|---|---|
|
2015 |
24% | 15% | 32% | 36% |
|
2016 |
25% | 16% | 35% | 38% |
|
2017 |
26% | 17% | 34% | 40% |
|
2018 |
28% | 18% | 36% | 43% |
|
2019 |
30% | 20% | 38% | 47% |
|
2020 |
32% | 20% | 40% | 52% |
|
2021 |
34% | 24% | 42% | 56% |
|
2022 |
35% | 24% | 44% | 55% |
|
2023 |
36% | 25% | 45% | 56% |
|
2024 |
39% | 27% | 50% | 58% |
|
Footnote: (1) The reference years refer to the month of March. |
||||
|
Source: U.S. Bureau of Labor Statistics, National Compensation Survey |
||||
Access to HSAs also increased by wage category. Ten percent of workers in the lowest 25 percent wage category had access to HSAs in March 2015 and 20 percent had access to HSAs in March 2024. For workers in the highest 25 percent wage category, HSA access increased from 37 percent in March 2015 to 62 percent in March 2024. (See chart 4.)
| Year | Lowest 25 percent | Second 25 percent | Third 25 percent | Highest 25 percent |
|---|---|---|---|---|
|
2015 |
10% | 23% | 29% | 37% |
|
2016 |
9% | 23% | 32% | 42% |
|
2017 |
9% | 24% | 32% | 42% |
|
2018 |
11% | 26% | 35% | 44% |
|
2019 |
13% | 27% | 36% | 48% |
|
2020 |
15% | 29% | 37% | 52% |
|
2021 |
16% | 32% | 38% | 55% |
|
2022 |
16% | 33% | 39% | 57% |
|
2023 |
19% | 33% | 40% | 57% |
|
2024 |
20% | 36% | 44% | 62% |
|
Footnote: (1) The reference years refer to the month of March. |
||||
|
Source: U.S. Bureau of Labor Statistics, National Compensation Survey |
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Access to HSAs varied by certain worker characteristics. For example, 24 percent of nonunion workers had access to HSAs, compared with 20 percent of union workers in March 2015. In March 2024, 39 percent of nonunion workers had access while 40 percent of union workers had access to HSAs. More full-time workers had access to HSAs than their part-time counterparts (29 percent compared with 9 percent) in March 2015 and (48 percent compared with 12 percent) in March 2024. Access to HSAs varied by other worker and establishment characteristics published by the NCS.
Whether an HDHP will save participants money depends on a variety of factors. The increased availability of HDHPs and HSAs provides employers and employees with additional flexibility to manage the cost of health care. Healthcare expenditures are a large component of the average household budget in the United States(2). While household healthcare insurance expenditures grew over 40 percent between 2014 ($2,868) and 2023 ($4,049), employer healthcare costs increased by 25 percent between 2015 and 2024 (3).
Additional resources:
- Latest news release
- Archived benefits news releases
- Annual Summaries of Benefit Coverage
- Employee Benefits glossary
- NCS classification page
- Pay Measure Comparison
Factsheets
- Introducing New Excel Tables for Employee Benefits
- Classifications systems used by the NCS
- Medical care premiums in the United States
Articles
- Coverage in employer medical care plans among workers in different wage groups in 2022
- 70 percent of private industry workers had access to medical care benefits in 2022
- Health care benefits take-up rate was 77 percent for private industry workers in March 2021
- High-deductible health plans for workers in private educational services in 2020
- Outpatient prescription drug benefits for workers in educational services in 2020
The glossary of employee benefit terms provides definitions for plans, provisions, coverage, and related terms.The glossary for health plan provisions for private industry workers provides additional information about the specific terms and concepts of health plan provisions. The National Compensation Measures Handbook of Methods provides information on the survey design, calculations, weighting, and imputation methods used to produce compensation estimates. The calculation section includes information on the measures of reliability available for each estimate.
Historical data
Estimates on the cost, coverage, and provisions of employer–sponsored benefit plans from 2010 to present are available through the XLSX dataset and public database. Historical data are available on the Annual Summaries of Benefit Coverage and Health and Retirement Plan Provisions pages. Benefit estimates are not a time series and users are advised to consider changes in survey design, survey scope, estimation methods, weighting, and sample rotation when analyzing the data.
END NOTES
(1) In the NCS, HDHPs are determined based on the individual deductible amount. See the NCS Handbook of Methods, Glossary of Employee Benefit Terms and the Glossary for Health Plan Provisions for Private Industry Workers for additional information.
(2) Based on the 2023 annual Consumer Expenditures Survey report.
(3) The household healthcare insurance expenditures is based on the Consumer Expenditures Survey health insurance (CXUHLTHINSRLB0101M) series. The Employer Costs for Employee Compensation provides measures costs of employer paid benefits and was calculated using the December health insurance cost per hour worked for private industry workers (CMU2150000000000D) series.
Last Modified Date: April 11, 2025