“Everyone is looking for solutions to a very broken system …and a solution to double digit trend increases,” said Jonathan Hensley, vice president of sales at Regence BlueShield, which has been offering HSA plans since October 2004.

A report released in September by the Kaiser Family Foundation says about 2.4 million people are now covered by so-called consumer-directed plans, which include HSAs. But while touted by many in the health care industry as a potential answer to ever-increasing insurance costs, the Kaiser survey showed that only 16 percent of employers believe HSAs would be “very effective” at controlling costs.

Is the HSA route the right one for your business? There are many aspects to consider before you could answer that question.

The HSA plan results in lower premium costs, Hensley said. In addition, consumers become “more engaged in the management of their care, and they like that.” He said it usually takes two to three years for employers to make buying decisions so the interest in these accounts is still peaking, but already “it has exceeded what we originally projected.”

The HSA has two components. One it has the high-deductible insurance plan, which has lower premiums. Two, it needs a separate account, usually administered through a bank. This account belongs to the employee, not the employer, and the employee can use it tax-free to pay for insurance deductibles or other medical expenses. Although there is a limit to how much money can be contributed each year, the unused portion is rolled over into next year. Some employers choose to fully fund this bank account, others split the contributions with the employees or let the employees do it alone. However, insurance industry surveys have found employees are less likely to opt for an HSA plan if the employer does not at least partially fund the savings account.

Sole proprietors also get tax benefits. “The main advantage is tax advantage,” said Frank Haberlach, a health insurance agent in Port Orchard who recently became the first HSA customer at Kitsap Bank. “I can take money out of my business to pay for medication, tax-free.”

Small businesses are more likely to sign up for HSAs simply because of their structures: They can make decisions in-house instead of going through the corporate chain.

Business owners may need to consider the needs of their workforce before taking the first steps.

“Because of the high deductibles, if you have a workforce in poor health, it's going to be tough for those employees, that's the trade-off,” said Todd Damish, a tax manager with Port Orchard-based accounting firm Southard Beckham Atwater & Berry CPA, PS.

Pacific Netting Products in Kingston made the decision to switch to HSAs in April. With six employees covered by insurance, and with an average employee age of 40, the company has already seen positive results.

“When we looked at health insurance, the premiums were getting so out of hand,” said the company's Dave Erickson. “We opted to try out the HSA accounts. The deductible is higher but the monthly premiums are less.”

He says the company's contributions are about the same as before because it shares the savings account contributions with employees. “For the amount of use, on average it looks to be a savings,” especially if “you're young, healthy and not using your insurance as much,” Erickson said, adding that so far his employees have been accruing money.

For healthy employees, that accrual is one of the most attractive aspects, in addition to the tax deductions. Employees making their own plan contributions don't have to itemize on their IRS tax returns to get a tax break, and they take the accounts with them if they change companies, Damish said.

One of the most important aspects for companies planning to offer or offering HSAs is communication, Regence BlueShield's Hensley said. Companies need to share their strategies with their workers, and use their health insurance offerings as part of a strategy that includes things like health fares, open enrollment meetings and other avenues.

“What we ultimately have is an informed consumer,” he said. “They make more appropriate decisions.”.