Health plans often use health risk appraisals (HRAs) as a starting point in engaging members in behavioral change. The authors examine characteristics associated with the voluntary completion of HRAs among enrollees in employer-sponsored insurance plans. They compare health care use, costs and participation in disease management programs for HRA completers and similar enrollees in plans that do not offer an HRA. Women, healthier people and people in consumer-driven health plans (CDHPs) are more likely than others to complete an HRA. Among those who complete an HRA, use of office visits, prescription drugs and cervical cancer screening increases compared to those who are not offered an HRA.