Janine was the CEO of Bingo Media, a mid-sized design firm that employed 43 people. In 2004, she considered switching her employees’ health plans to CDHPs. When Janine suggested the switch to her team, the concept of CDHPs appealed to almost everyone. Choosing CDHPs was the easy part; deciding on an account structure would present a challenge.

Janine met with the heads of HR and administration to discuss their options. They ruled out FSAs quickly because they didn’t like that they were solely employee-funded and that there was no potential for rollover. Without these perks, they felt that employees would be less inclined to get involved and make significant lifestyle changes.

Next, they considered HRAs. They liked that these accounts were employer-funded, allowing them to contribute to their employees’ health plans, but that they were notional accounts, so no money had to actually be paid by the company until an expense was incurred, which made them feel like a less risky proposition. Janine liked the use it or keep it aspect of the plan because she wanted her employees motivated to make informed choices. She and the other decision makers chose to go with this option.

One year later, renewal time arrived. The implementation and use of the plan had been a success, and Janine could tell that people had connected with the system and were making positive changes in their lives. However, she knew there was still room for improvement. After several meetings, it became clear that the main issue holding her employees back was that the money didn’t feel like their own. Although the balance of the notional account was rolling over from year to year, people didn’t feel like they were saving money and building equity.

When Janine renewed the company’s plan, she switched it to an has, and she noticed the change immediately. Her employees were more proactive in seeking preventive and alternative care, and they made lifestyle changes that improved their health and reduced their reliance on healthcare. It took a year, but Bingo Media found the plan that worked for them, and they’ve been reaping the benefits ever since.