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.

The HSA market in Virginia continues to be active. At least 17 companies have offered HDHPs in Virginia in 2019, and at least 272,338 Virginians were covered by HDHPs at the end of 2018. This is a slight decrease from the 18 companies that sold HDHPs and the 275,842 lives covered by HDHPs at the end of 2017. Overall, the market appears to have leveled off over the past two years as compared to 2016 and earlier.

No state legislative or regulatory barriers to the sale of HDHPs have been identified that would restrict the attractiveness of HDHPs to Virginians. However, over the last few years changes in federal regulatory rules have caused marketplace disruptions in the individual health insurance market, resulting in decreases in 2018, in both the number of companies offering HDHPs and the number of lives covered by HDHPs, compared to 2016. 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.