We, too, have seen an increase in demand for mental health services, and doubled our annual maximum/covered member recently for that reason. As for underutilized HSA, we identified this about 10 years ago. At that time, we introduced the option of a Wellness (taxable) Spending account as an option for employees. So, each year, plan members get to choose how to allocate their spending account credits (including being able to split them between the two). Eligible expenses under the taxable account include things like: sports equipment, registered arts and fitness classes, monthly/annual sports facility passes, alternate health therapies (not covered under HSA). Since the introduction of this option, we have seen a significant drop in forfeited credits. We manage the administration of the taxable account in-house and reimburse through payroll, and the non-taxable HSA is still through our third-party benefits carrier.