Delaware County commissioners heard an informational presentation Nov. 22 about health savings accounts, a federal tax structure that allows county employees to purchase lower cost high-deductible health insurance plans.

Delaware County commissioners heard an informational presentation Nov. 22 about health savings accounts, a federal tax structure that allows county employees to purchase lower cost high-deductible health insurance plans.

The commissioners said they were not deciding to implement such plans right now, but would hold a series of presentations during the coming year to consider doing so in 2012.

Sherri Noll, director of the County Employee Benefit Consortium, which includes 23 Ohio counties, said, "A health savings account is held by the individual and it's used for current and future medical services. They're used in conjunction with a high-deductible health plan."

Under the plan, employees are given their own savings account that can be used like any other savings account, which is not taxed when used for authorized medical expenditures.

Noll said employees in theory could use the account for anything they chose, such as a dinner at Applebee's, but if they do so they will incur a tax liability.

Under the plan, the employer and the employee both contribute to the savings account each year, up to a maximum of $3,050 for a single person and $6,150 for a family.

If the money is not used during the year, it stays in the account, which receives a similar contribution the following year.

Noll said the point is to give employees an incentive to think about how they were spending their health care dollars.

"Consumer driven health plans help employees make intelligent decisions on health care because they have some skin in the game," Noll said. "If you have a first dollar program now, people don't think twice about going to the emergency room. Any trip to the emergency room is a minimum of $1,500."

Preventive care is paid for by the insurance plan, Noll said, not the health savings account.

The most difficult part of the plan is learning how to use it, Noll said.

"The educational process is difficult for employees," Noll said. "People can be freaked out at the prospect of changing the ways they're used to receive insurance."

Employees also have a high-deductible insurance plan to cover expenses above the deductible amounts.

The minimum deductible is $1,200 for a single person and $2,400 for a family.

"Normally, you have lower insurance premiums because you have higher deductibles," Noll said.

One county made a planning mistake of providing 100 percent funding of the health savings account, and as a result saw premium increases of more than 40 percent because of overuse.

She said the county should fund only part of the health savings account.

Commissioner Ken O'Brien said he is familiar with the health savings accounts used at Worthington schools.

"It took about a year for buy-in of the employees," O'Brien said. "But everyone found they were able to take control over what they wanted to spend the money on."

O'Brien said Worthington's health savings account contribution mix was $2,000 each year from the district and $1,000 from the employee.

Employees are allowed to make additional contributions tax free, so long as they do not exceed the annual maximum contribution amounts set each year by the federal government.