The Virginia State Corporation Commission (“Commission") submits this updated report in accordance with the Virginia Health Savings Account Plan, §§ 38.2-5601 through 38.2-5604 of the Code of Virginia. Health Savings Accounts (“HSAs") were created by federal legislation and are designed for use with High-Deductible Health Plans (“HDHPs"). By law, the Commission is required to provide information on the availability of HDHPs in Virginia and recommendations for legislation that would increase the attractiveness of HSAs or eliminate barriers to their use.

There is considerable activity in the HSA market in Virginia even though there has been a decrease in HDHP business from the previous year. There are at least 18 companies that offer HDHPs in Virginia, and at least 275,842 Virginians were covered by HDHPs at the end of 2017; this is a decrease from 22 companies and 374,000 covered lives at the end of 2016. No state legislative or regulatory barriers to the sale of HDHPs have been identified that would restrict the attractiveness of HDHPs to Virginians. However, 2017 witnessed changes in federal regulatory rules that caused marketplace disruptions in the individual health insurance market, resulting in decreased HDHP sales as well as a decrease in the number of insurers offering health insurance plans in certain geographical areas in Virginia. The Bureau of Insurance will continue to monitor the Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 et seq. (2010), and subsequent regulations, as well as other federal legislation and market activity in Virginia. The Bureau of Insurance has no recommendations for legislative changes at this time.