How does the single-card solution for benefits and savings accounts test with health plan members?

Let's look at the 2022 Healthcare Benefit Census to see how the solution tested

When it's time to pay for health care, a health plan member likely considers the following:

  • Which benefit can I use to pay for this service?
  • Can I use my HSA?
  • Did I remember to bring the card with me?

These are some of the questions that a member must consider in order to select the right payment tool for a medical expense. In this excerpt from The 2022 Healthcare Benefit Census, we'll review member opinions regarding a potential solution: a single benefit card that uses health wallet technology to apply the appropriate benefit or savings account.

A Note on The 2022 Healthcare Benefit Census

First Dollar recently commissioned The Harris Poll to survey 1,000 U.S. adults with health insurance and either a flexible spending account (FSA) or a health savings account (HSA). (We'll refer to them as "members.") You can read and download the entire report here.

Recap of Member Pain Points

We asked members about their experience with their current health plan. We did this so we could identify two groups: fans and detractors, For this blog post, we’ll refer to any member who answered “very positive” or “somewhat positive” as a health plan fan, and anyone who answered “somewhat negative” or “very negative” as a health plan detractor.

Here are some of the pain points we discovered for health plan detractors. Detractors:

  • Struggle to track their benefits (75%).
  • Don't use all of their benefits (60%).
  • Don’t know all of their benefits (48%).

Based on that data, health plans who solve these pain points will likely have higher NPS and member retention metrics.

Additional Service and Complexity for Members

Let's take a second to look at healthcare spending management through the member's eyes. To make the best choices for their health care spending, members need to understand and master each additional health care payment tool (benefit, tax-advantaged account). Let’s consider some of the questions members are forced to navigate.

  • What’s my HSA annual contribution limit?
  • What drugs are covered by my prescription benefits?
  • When do my FSA funds expire?
  • What’s my password and login for this account?

graph of a worried man trying to answer the questions about all of his benefits and tax-advantaged accounts
example of a member trying to manage their healthcare benefit and payment options

That's a lot of questions for members to answer on their own.

Missed Opportunities

If health plans fail to mitigate these member tasks, they risk members not maximizing existing and new benefits, resulting in hard-earned money left on the table.

FSA Example: Every year, a large portion of FSA funds go unused. If members do not use their flexible spending account (FSA) funds by their annual expiration date, they forfeit the remaining FSA balance. That’s money that members could have used to buy healthcare services, saving their own hard-earned money and maintaining their health (e.g., buying sunscreen).

Did You Know? In 2019, 44% of workers forfeited part or all of their FSA contributions. The average forfeiture was $339, and the median forfeiture was $157.

Streamline Payments

When it’s time to pay for health care under the deductible, members today may choose to use their HSA, FSA, DCFSA, cash, or a supplemental benefit provided by their plan or employer. This number of payment options can lead to confusion as members are left on their own to identify the right payment tool. And payments are a fundamental facet of how people experience healthcare as members associate their payment experience with their health plan experience. There is no dividing line.

Did You Know?: In 2019, United States out-of-pocket spending per capita reached $1,241.

The Cost of Complexity

Complexity has a cost. A 2017 Accenture report found that more than half of U.S. consumers cannot navigate the complexity of the healthcare system on their own, costing payors an estimated $4.8 billion annually in administrative expenses alone. And it’s unfortunately unsurprising that more than one in four people avoid treatment due to uncertainty about their coverage.

Complexity for Plans, Too

Our study focused on member pain points, but benefit complexity also impacts health plan providers. Adding new accounts (and their respective vendors) results in uncoordinated administration with multiple vendors managing multiple benefits. And as health plans continue to add new benefits to differentiate their offering, the problem continues to grow.

What if health insurance plans had a health wallet platform that enabled them to stack benefits? A health wallet platform with stacked benefits would allow individuals to use a single card, a single login, and a single password for all of their benefits.

Single-Card Solution

We proposed a single-card solution to survey respondents that streamlined benefits for members. Instead of the member answering the question, “Which card should I use to pay for healthcare services?” the single-card solution would apply the appropriate benefit for the health care payment. Members would only need to carry and remember their one health care card. And this single-card solution would allow health plans to stack their benefits, using one platform to streamline all of their offered benefits.

We asked members if they would switch to a health plan that offered the single-card solution.

horizontal bar graph showing that four in five health plan detractors would likely switch to a plan that offered the single-card solution
four in five health plan detractors would likely switch to a plan that offered the single-card solution

Almost four in five detractors said they would likely switch to a plan that offered the single-card solution. This was also true for health plan fans, as four in five fans said they would be likely to switch to a plan that offered the single-card solution.


Members see the single-card solution as a driving incentive to switch plans. The single-card solution is a hit!

Read The 2022 Healthcare Benefit Census

This blog post is an excerpt from First Dollar's 2022 Healthcare Benefit Census: Understanding Benefit Utilization and Member Dissatisfaction. To review all of the report's findings, you can review the complete report here.

Research Methodology

First Dollar commissioned The Harris Poll to conduct an online survey of 1,000 U.S. adults between February 15 - February 17, 2022. To qualify for the survey, respondents met the following conditions: have healthcare insurance and either a flexible spending account (FSA)
or a health savings account (HSA).