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Nationwide Retirement Institute Survey Finds Few Business Owners Fully Understand Health Savings Accounts and Are Hungry to Learn More

Majority expect guidance from a financial advisor

New research from the Nationwide Retirement Institute® finds the majority of business owners (55 percent) consider the cost of healthcare to be the biggest expense for those in retirement, outpacing housing (24 percent), taxes (12 percent), food (6 percent) and transportation (1 percent).

Yet, just one in five (20 percent) business owners fully understand important elements of health savings accounts (HSAs), according to the survey of 406 U.S. business owners with 11-500 employees.

Among those surveyed, many didn’t understand that it’s necessary to provide a high-deductible health plan (HDHP) when offering an HSA, that employers can contribute to employee plans and HSA balances carry over year-to-year. These findings demonstrate the misconceptions and barriers that exist in helping employees save for current or future healthcare expenses.

Meanwhile, three in four U.S. business owners expressed interest in talking to a financial advisor about employee benefits that reduce company taxes (77 percent), offer employee tax savings (74 percent) or may increase retirement savings (76 percent).

“Business owners want to talk about employee benefit solutions that offer tax savings and can help increase retirement savings,” said Kristi Rodriguez, leader of the Nationwide Retirement Institute. “A real opportunity exists for financial advisors to play a major role in educating business owners about the benefits of health savings accounts for both their business and their employees.”

Uncertainty may create barriers 

Business owners who already offer an HSA report that the main benefits are providing tax advantages (56 percent) and the ability to cover healthcare deductibles and out-of-pocket expenses (58 percent). Less than half (43 percent) say saving for retirement is an advantage associated with HSAs. In contrast, those who don’t offer HSAs and are not considering one say they are unsure of the advantages associated with HSAs.

In addition to misconceptions around the benefits of an HSA, a gap exists in understanding that businesses must provide a HDHP to offer an HSA. Six percent of business owners with 101-500 employees answered that their business offers an HSA despite indicating they did not offer an HDHP option, which would not be possible.

“Health savings accounts are effective tools for business owners and employees alike,” said John Carter, president of Nationwide’s retirement plan business. “They can supplement retirement savings plans by promoting greater savings and easing retirement concerns around healthcare costs, while offering special tax treatment not found in other retirement accounts.”

Four out of ten (41 percent) business owners offer their employees an HSA. Another 21 percent are considering one and 38 percent state they are not considering an HSA. The larger the business the more likely it is to offer an HSA: 59 percent of companies with 51 to 100 employees offer an HSA and 60 percent of companies with more than 100 employees offer one, compared to only 25 percent for companies with 50 or fewer employees.

Millennial business owners lead the way

Today, 81 percent of Millennial business owners offer an HSA option, compared to 44 percent of Gen X and 25 percent of Boomer owned businesses.

Millennial business owners also possess a solid knowledge about the important elements of HSAs, in addition to how HSAs can be advantageous for them and their businesses. However, only 31 percent of Millennial business owners knew that HSA balances carry over year-to-year. Lastly, Millennial business owners expressed the greatest interest in speaking with a financial advisor about benefits associated with HSAs, with at least 90 percent saying they’d be interested.

“In an economy with low unemployment, employers are competing for talented workers. Benefits play a key role in attracting and retaining employees,” noted Carter. “We believe the growth of health savings accounts follows the same upward trajectory of defined contribution plans. As employers become more familiar with health savings accounts, advisors need to help ensure they understand the associated benefits.”

To help advisors have these conversations the Nationwide Retirement Institute offers advisors a variety of educational resources and tools, including Nationwide’s Health Care Cost Assessment. This tool provides a meaningful, personalized cost estimate that helps advisors and clients estimate future medical and long-term care expenses.

Financial advisors who are interested in learning more about HSAs, upcoming webinars or obtaining complimentary healthcare cost assessments for clients, should call 1-800-626-3112 or visit


Nationwide commissioned Edelman Intelligence to conduct a 10-question, online survey through the YouGov panel between February 14-22, 2019, among a sample of 406 U.S. business owners. Business owners are defined as having between 11-500 employees, being 18 years or older and self-reporting as either a sole or partial owner of their business. The margin of error for this sample was +/-4.9 percent at the 95 percent confidence level. As a member of CASRO in good standing, Edelman Intelligence conducts all research in accordance with Market Research Standards and Guidelines. For this survey, Millennials are defined as ages 18-34, Gen X as ages 35-54 and Boomers as age 55 and older.

About Nationwide

Nationwide, a Fortune 100 company based in Columbus, Ohio, is one of the largest and strongest diversified insurance and financial services organizations in the United States. Nationwide is rated A+ by both A.M. Best and Standard & Poor’s. An industry leader in driving customer-focused innovation, Nationwide provides a full range of insurance and financial services products including auto, business, homeowners, farm and life insurance; public and private sector retirement plans, annuities and mutual funds; excess & surplus, specialty and surety; pet, motorcycle and boat insurance. For more information, visit Follow us on Facebook and Twitter.