Health-care accounts benefit some but are hardly a cure-all Employees pondering their healt... Health-care accounts benefit som

Employees pondering their health-care options during the traditional fall open enrollment period might have something new to consider this year.

HSAs also are a good indicator of which way the wind is blowing for the American worker. It's the same chilly blast employees are feeling as corporations yank back the security blanket on pensions.

"Just as we all had to learn to plan for our retirement, we all have to plan for our health-care costs," says Jon Kessler, founder and chairman of San Mateo, Calif.-based WageWorks, which manages HSAs as well as commuting and flexible spending accounts for such large employers as Bank of America and the U.S. Postal Service.

Employees pinched by the bite health-care premiums take out of their checks will be pleased to learn contributions to an HSA are an average of 30 percent less than for a traditional plan. They also can save pretax dollars to pay for doctor's visits, prescriptions and other health-related expenses that might not be covered otherwise.

Workers can continue to save any money in the account they don't use during the year. It's a portable benefit you can take with you when you change jobs or retire.

That sentiment is echoed in the workplace. At small businesses, only 15 percent of employees are opting for HSAs, Kessler says. At companies with 1,000 or more workers, which typically offer a bigger slate of benefits, fewer than 4 percent of employees are taking the HSA route.

"It just doesn't make sense for families with small children, older workers or anybody who has any kind of ongoing health problem," he says. "When you have to pay, the savings disappear quickly."

Kessler says they might be the perfect match for two specific consumer groups: Young singles with no apparent health problems and self-employed business people.

"If you're young and healthy you can live on a skimpier policy," he says. "And if you're self-employed, you're probably already stuck in a skinny health plan with a high deductible."

Although they are patently imperfect, Kessler says HSAs are unlikely to go away. He suggests workers get their feet wet by signing up for Flexible Spending Accounts, in which they set aside pretax dollars to pay for uncovered medical costs and over-the-counter medications.

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