First Dollar Publishes U.S. Healthcare Benefits Utilization Findings


While upcoming healthcare legislation seeks to expand access to benefits like mental health treatment, it is equally important to understand how we can increase healthcare benefits utilization by making people more aware of the benefits they have and how to pay for them.

First Dollar, the health wallet for modern, member-first plans powering software-defined benefits, announced findings today from their survey conducted online within the United States by The Harris Poll. The survey was conducted between February 15 and February 17, 2022 among 1,000 U.S. adults ages 18+ who have healthcare insurance and have a Flexible Spending Account (FSA) or Health Savings Account (HSA).

First Dollar published a whitepaper (“The 2022 Healthcare Benefits Census: Understanding Benefits Utilization and Member Dissatisfaction”) detailing their findings, which you can download here.

While the majority of those with health insurance plans are satisfied with their plans and the benefits offered, it is worth examining what leads to people being dissatisfied with their health plan. The survey found that those who described their overall experience with their health plan as negative (11%) were more likely to not be aware of their benefits than those who describe their overall plan as positive (89%). Conversely, of those who viewed their plan positively, 81% were aware of all of their healthcare benefits. This is compared to only 52% of healthcare plan detractors (i.e., those who describe their plans negatively) being aware of all of their healthcare benefits.

While upcoming healthcare legislation seeks to expand access to benefits like mental health treatment, it is equally important to understand how we can increase healthcare benefits utilization by making people more aware of the benefits they have and how to pay for them.

When those who were not aware or unsure of their benefits (22%) were asked why that was the case:


  • 42% said that there were too many benefits to keep track of
  • 37% didn’t know where to find the information about their benefits
  • 32% said that they did not have time to look into all of their benefits.

Members who struggle understanding their benefits want a healthcare experience that works, not just another benefit added. “We found a relationship between awareness of benefits offered and health plan satisfaction,” said Jason Bornhorst, CEO and Co-Founder of First Dollar. “Yet, most health insurance companies are doing the absolute minimum to educate customers and offer a streamlined solution.”

The study also found that 78% of detractors would be at least somewhat likely to switch to a plan that offered a single card. With First Dollar, customers can now access benefits and pay for them within a single, unified experience.

This month, Arizton Advisory & Intelligence released their latest research report on the U.S. financial wellness benefits market, which notes that the “U.S. financial wellness benefits market size was valued at USD 446 million in 2021 and is expected to reach USD 965 million by 2027,” growing at a CAGR of 13.71%. The top 3 segments contributing to the market are financial planning, financial education & counseling, which are expected to add over $450 million over the next five years.

Despite heavy investment in the market, it remains difficult for consumers to access their benefits. “Consumers are presented with multiple, complicated legacy systems that rarely speak to one another,” Jason Bornhorst continued. “This onerous process often leads to people not understanding their benefits or how to pay for them. First Dollar is making healthcare payments easier so that health plans, TPAs and other benefits platforms can better serve and support their members.”

To download “The 2022 Healthcare Benefit Report: Consumer Benefit Pain Points,” please visit: https://www.firstdollar.com/whitepapers/2022-healthcare-benefits-census

About First Dollar

First Dollar is the health wallet for modern, member-driven plans. We power software-defined benefits that people love to use. From HSAs and FSAs to prepaid grocery and Rx programs, our payments infrastructure supports tax-advantaged accounts, supplemental benefits, and whatever you dream up next.

To learn more, please visit: http://www.firstdollar.com.

Research Methodology

The research was conducted online within the United States by The Harris Poll on behalf of First Dollar among 1,000 U.S. adults ages 18+ who have healthcare insurance and have a Flexible Spending Account (FSA) or Health Savings Account (HSA). The survey was conducted between February 15 – February 17, 2022.

Data are weighted where necessary by age, by gender, household income, region, education, race/ethnicity, size of household and marital status to bring them in line with their actual proportions in the population. A propensity score variable was also included to adjust for respondents’ propensity to be online.

Respondents for this survey were selected from among those who have agreed to participate in our surveys. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within +4.2 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest.

All sample surveys and polls, whether or not they use probability sampling, are subject to multiple sources of error which are most often not possible to quantify or estimate, including, but not limited to coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments.

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