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Benefits in the News > By Subject >

Health savings accounts (HSAs)


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How Employees Can Make Themselves Ineligible for HSA Contributions
"In 2004, the [IRS] confirmed that an employer only has three responsibilities regarding HSA eligibility and communicating this to the HSA custodian: [1] Ensure the employee is covered by an HSA-eligible high-deductible health plan (HDHP) sponsored by the employer; [2] Confirm that the employee is not covered by any non-HDHP coverage sponsored by the employer; and [3] Provide the employee's age (for purposes of the catch-up contribution). So why should employers care about HSA disqualification if it is primarily an employee concern?" (HR Daily Advisor)
[Opinion] HSAs Play Important Role in Addressing America's Retirement Challenge
"[I]ncreasing the annual HSA limits to align with high-deductible health plan out-of-pocket maximums and enacting policies to encourage the use of HSAs to save for medical expenses in retirement could be important components in closing the retirement savings gap and enabling more Americans to retire with confidence." (Mercer)
Effect of On-Site Clinics on HDHPs and HSAs
"An on-site health clinic may offer the following permissible medical benefits at no cost, without affecting HSA eligibility: 'permitted' coverage (such as vision and dental care), 'preventive care' (such as shots and screenings), and 'insignificant' medical benefits (collectively, permissible benefits).... If an on-site clinic provides 'significant benefits' for free or at reduced-cost (i.e., below fair market value), an employee may lose eligibility for an HSA." (Jackson Lewis P.C.)
The Deal with Health Savings Accounts
"Is there a business opportunity for advisors to charge into the HSA marketplace when the bulk of assets in HSAs are not being invested, and when what can be contributed annually is still a fairly small amount?" (Morningstar)
The HSA Opportunity, Explained
"[HSAs] never expire and may be invested. The accounts have a triple tax advantage: tax deductible, tax-free withdrawals, and tax-free earnings on investment returns. Many people do not fully understand the implications of these features.... [J]ust over a third of employees who are covered by a HSA-qualified plan actually contribute. Even more dramatic, less than 3% of HSA account holders currently invest." (BNY Mellon)
[Guidance Overview] ACA Numbers and Limits: Reference Guide (PDF)
One-page chart lists numerous dollar limits for 2014-2018, including: [1] 4980H Large Employer Shared Responsibility Penalty; [2] 5000A Individual Shared Responsibility Penalty; [3] 36B Marketplace Subsidies/Premium Tax Credits (PTC); [4] Health Insurance Reforms; and [5] Health Savings Accounts. (Kaufman & Canoles, P.C.)
Can Employees Pay for Cord Blood Storage with an HRA, FSA or HSA?
"[If] the storage is merely precautionary, then the storage wouldn't be a qualified medical expense. If there's a current need (for example, the baby or a sibling or parent is actually sick and could benefit from the cord blood in the short term) then there's an argument to count the cord blood storage as a qualified medical expense and allow reimbursement of the costs through an HRA, FSA or HSA." (Mintz Levin)
Health Savings Accounts: The Tax Code's Next Sleeper Hit
"The tax treatment of HSA contributions can help ease the potential burden of these higher out-of-pocket costs. Combined with the HSA's flexibility, these tax breaks are attracting people interested not only in paying for health care, but also in saving for long-term goals such as retirement or a child's education. Enrollment in HDHPs, and thus access to HSAs, is growing rapidly." (Vanguard)
Most HSAs Rolled Over Money at the End of 2016
"[O]ver 90 percent of HSAs with individual or employer contributions in 2016 ended the year with funds to roll over for future expenses. Two-thirds of account holders ended 2016 with positive net contributions, meaning annual contributions were higher than annual distributions ... As of the end of 2016, the average HSA balance among account holders with individual or employer contributions in 2016 was $2,532, up from $1,604 at the beginning of the year." (Wolters Kluwer Law & Business)
[Opinion] The Love-Hate Relationship with HDHP-HSAs
"The complexities of our often-dysfunctional healthcare system need not victimize the patient if employers support these 'consumer-driven' health plans (CDHPs) with key investments -- in education, cost and quality decision-support tools, and advocacy to help with navigating the confusing system. Without correlating resources, poorly managed plans are nothing more than a cost shift, with the lowest socioeconomic groups too often paying the highest price in insufficient or inappropriate care[.]" (Conduent)
Health Savings Account Balances, Contributions, Distributions, and Other Vital Statistics, 2016 (PDF)
32 pages. "Enrollment in high-deductible, HSA-eligible health plans was estimated to be between 20.2-22.6 million policyholders and their dependents, and covered nearly 3 in 10 employees in 2016.... [T]here were an estimated 20 million HSAs as of the end of 2016.... Over 90 percent of HSAs with individual or employer contributions in 2016 ended the year with funds to roll over for future expenses. As of the end of 2016, the average HSA balance among account holders with individual or employer contributions in 2016 was $2,532, up from $1,604 at the beginning of the year." (Employee Benefit Research Institute [EBRI])
Medicare and HSA Eligibility
"Simply gaining eligibility for Medicare doesn't disqualify employees from staying on your high deductible plan or from contributing into an HSA.... Enrollment in Medicare (Parts A, B, C, or D), versus becoming eligible for Medicare, disqualifies an employee from making or receiving contributions to an HSA. However, enrollment in Medicare does not impact their eligibility to enroll in the HDHP, as HSAs are independent offerings from a HDHP, or request reimbursement from their HSA.... To avoid penalties, older workers should be advised to stop contributing to their HSA account six months before applying for their Social Security benefits." (HUB International)
Guide to Investing Your HSA Account for Growth
"HSAs offer a triple tax advantage ... Withdrawals for qualified medical expenses are always tax-free, regardless of your age ... After age 65 you can use withdrawals for any expense, although they will be taxed at your normal rate.... With maximum annual contributions and minimal medical expense withdrawals, you can build a hefty nest egg to complement your regular retirement plan." (DataPath)
Educate Your Employees on Using HSAs In Retirement Planning
"With healthcare open enrollment season quickly approaching, 401k plan sponsors may want to spend some time educating participants on the use of Health Savings Accounts (HSAs). If you offer a High-Deductible Health Plan (HDHP) to your employees, they probably have the ability to contribute to HSAs.... [N]early everyone eligible to contribute to an HSA should max out their HSA contributions each year. Here's why." (Lawton Retirement Plan Consultants)
[Official Guidance] IRS Publication 1220: Specifications for Electronic Filing of Forms 1097, 1098, 1099, 3921, 3922, 5498, and W-2G for Tax Year 2017 (PDF)
150 pages, August 2017 revision date. Includes a "First Time Filers Quick Reference Guide" with information about Form 4419, Application for Filing Information Returns Electronically (FIRE), which is used to request authorization to file Forms 1097, 1098 Series, 1099 Series, 3921, 3922, 5498 Series, 8027, 8955-SSA, 1042-S, and W-2G electronically through the Filing Information Returns Electronically (FIRE) System. Excerpt: "Allow a 45-day processing timeframe prior to the earliest information return due date." (Internal Revenue Service [IRS])
How to Educate Employees During Open Enrollment (PDF)
"[1] Communicate contribution limits.... [2] Communicate plan extensions and deadlines.... [3] Explain how to track expenses.... [4] Teach them about eligible expenses.... [5] Reduce paperwork with an FSA or HSA debit card.... [6] Anticipate common questions.... [7] Explain investment opportunities." (FSA Store)
Transferring IRA Money to a Health Savings Account
"People who still qualify to make HSA contributions can make a one-time rollover from an IRA to an HSA, which can be a good way to build up the account if you don't have other cash to contribute. You must currently have an HSA-eligible health insurance policy with a deductible of at least $1,300 for single coverage or $2,600 for family coverage. The amount you can roll over is the same as your annual HSA contribution limit[.]" (Kiplinger)
How to Keep HSAs Exempt from ERISA
"Employers should not: [1] Make employees' contributions to an HSA involuntary. [2] Limit employees' ability to move funds to another HSA. [3] Impose conditions on the use of HSA funds.... [4] Influence HSA investment decisions. [5] Represent that the HSA is subject to ERISA. [6] Receive payment in connection with the HSA." (Society for Human Resource Management [SHRM])
HSAs to Lead the Way After ACA
"If President Trump signs into law any form of an ACA repeal/replace bill, it is likely to put HSAs in an even greater spotlight than they have already earned since their introduction roughly a decade ago.... At a minimum, [this] will create a major new incentive to use HSAs as a long-term savings vehicle. But the possibilities are far larger than that.... [T]he proposed HSA changes could be no less than the end of the employer-sponsored group health plan as we know it." (ABD Insurance & Financial Services)
Can I Have an HRA and HSA at the Same Time?
"HRA plan types that are compatible with an HSA: [1] Limited purpose HRA ... [2] Post-deductible HRA ... [3] Retirement HRA ... [4] Suspended HRA." (DataPath)
2017 Midyear HSA Research Report (PDF)
"The number of HSA accounts surpassed 21 million, holding about $42.7 billion in assets, a year over year increase of 23% for HSA assets and 16% for accounts ... HSA investment assets reached an estimated $6.8 billion in June, up 44% year over year. The average investment account holder has a $15,146 average total balance ... Health plan partnerships continued as the leading driver of new account growth, accounting for 36% of new accounts opened in 2017 so far." (Devenir)
The HSA in Your Future: Defined Contribution Retiree Medical Coverage
"[O]nly 24% of employers with 200 or more employees offer retiree health coverage ... The percentage of smaller employers offering retiree medical coverage is much, much less.... [L]ess than 5% of America's workers have access to and save on a tax-favored basis for future medical expenses -- including HSA-qualifying expenses[.]" (Plan Sponsor Council of America [PSCA])
[Opinion] ECFC Comment Letter to DOL on Application of Fiduciary Rule to HSAs (PDF)
"ECFC members believe that to impose the same fiduciary requirements for HSAs as are imposed on [IRAs] is administrative overreach by the Department. The Department can justify its need to regulate IRAs under the Fiduciary Rule since IRAs frequently are a conduit for ERISA-covered retirement plans. The same cannot be said of HSAs.... If the Department does not agree with ECFC's re commendation that HSAs should not be subject to the Fiduciary Rule, the Department should permit HSAs to be eligible for the platform provider exception in the Prohibited Transaction Exceptions." (Employers Council on Flexible Compensation [ECFC])
What Happens to Your HSA in Retirement?
"In addition to gauging HSA quality, long-term HSA investors need to consider the logistics of managing their HSAs, especially if their plan is to carry the HSA assets into retirement. How should HSA assets be allocated during retirement? Where in the retirement-funding queue do these accounts belong? And importantly, what would happen to your HSA if you were to pass away before you spent all the money?" (Morningstar)
HSAs With the Best Investment Menu Designs
"An HSA plan's investment menu should offer a comprehensive set of options so that do-it-yourself investors can build well-rounded portfolios.... [It's] prudent to offer multi-asset-class funds, which offer built-in asset-class diversification, for hands-off investors who wish not to construct or closely monitor their portfolio.... HSA plans should resist offering overlapping investment strategies.... Plans that receive positive scores offer investment strategies in core asset classes and have limited redundancy of investment options." (Morningstar Advisor)
People Don't Take Full Advantage of Health Savings Accounts
"A recent report ... indicates that account holders appear to be using HSAs as a special checking account instead of an investment vehicle, despite tax incentives offered to participants that wish to set aside money for future medical expenses.... While employers hope that these account-based plans will encourage employees to shop around for the most cost-effective health care, [another] study indicates employers may also want to do their own shopping when deciding which HSAs to offer." (Bloomberg BNA)
How a Mid-Year Change of Status Affects HSA Contributions
"[An] HSA-eligible individual who has a mid-year status change will have his new annual contribution limit determined by whichever of the following two options results in the highest amount: [1] The maximum annual contribution limit based on his or her actual HDHP coverage (individual or family) for each month of the tax year, calculated monthly, combined and then divided by 12; or, [2] The maximum annual contribution limit for the tax year based on his or her actual HDHP coverage (individual or family) as of December 1 of that year." (DataPath)
The Impact of Offering Free Coverage on Enrollment Choice and Risk Selection in an HSA-Eligible Health Plan (PDF)
20 pages. "After eliminating employee premiums for all coverage tiers, HSA-eligible health plan enrollment increased from 4 percent to 25 percent among individuals with employee-only coverage and from 3 percent to 28 percent among individuals with family coverage.... Offering coverage with no payroll deduction attracted individual enrollees who were marginally healthier than those who would have enrolled without this financial incentive in place, therefore adverse selection was not mitigated as anticipated." (Employee Benefit Research Institute [EBRI])
Trends in HSA Balances, Contributions, Distributions, and Investments, 2011-2016 (PDF)
24 pages. "On average, account holders appear to be using [health savings accounts] as specialized checking accounts rather than investment accounts.... Longer experience with HSA improves account holder prospects for financial security.... Over time, account owners appear to see the value in investing." (Employee Benefit Research Institute [EBRI])
[Guidance Overview] New Fiduciary Rule Takes Effect for Health Savings Accounts (PDF)
"While acknowledging that HSAs generally hold fewer assets and may exist for shorter durations than IRAs, the DOL determined that HSA owners are entitled to receive the same protections from conflicted investment advice as IRA owners. The DOL also recognized that HSAs may have associated investment accounts that can be used as long-term savings accounts for retiree health care expenses. In addition, the DOL clarified that the final rule does not apply to recommendations to welfare plans (such as health plans, disability plans or term life insurance) where they do not contain an investment component." (Cowden Associates, Inc.)
[Opinion] Perhaps Employees Just Don't Want HSAs
"People don't like high-deductible health plans.... When we consider that a typical employee's paycheck is already being 'raided' by federal income taxes, state income taxes, FICA taxes, health benefit costs, 401(k) deferrals, and other benefit costs, there may not be enough left over for the day-to-day costs of living let alone HSA deferrals.... If participation in an HDHP is an entrance requirement, your average participant just doesn't care about the possible benefits of a health savings account." (Benefits and Compensation with John Lowell)
Retiree Health Costs Demand Financial Wellness
"The value of HSAs has become increasingly apparent as employers come to align them more closely with 401(k) plans, through efforts such as unified education, integrated dashboards, and similar investment menus. The result is that employees are starting to use HSAs for what they were initially designed: for long-term savings." (CFO)
Here We Go Again: The Senate's Health Reform Bill
"The Senate bill proposes to remove the dollar limit on health flexible spending account contributions by employees effective after December 31, 2017. Currently many employers are preparing for annual enrollment for the next calendar year and may want to address this limit if it is made unlimited rather than having an unlimited amount. The Senate bill also proposes to make over the counter medical expenses reimbursable under health savings accounts (HSAs), health flexible spending accounts (HFSAs) and under health reimbursement accounts (HRAs) effective after December 31, 2016." (Winstead PC)
Health Savings Account Landscape 2017
46 pages. "Out of the 10 plans [the authors] evaluated, only one looks compelling for use as a spending vehicle and an investment vehicle, suggesting there is much room for improvement across the industry ... Account maintenance fees represent the most important consideration for accountholders intending to use their HSAs as a spending vehicle. The current low-interest-rate environment means accountholders will generate little income from the checking accounts offered by HSAs ... As compared with retail mutual funds, the all-in cost of investing in the HSA plans ... ranges from cheap to expensive." (Morningstar)
Non-Delay of DOL Fiduciary Conflict of Interest Rule Has Impact on HSA Custodians and Trustees
"Despite the transition relief, DOL appears to expect some diligence to ensure compliance with the Impartial Conduct Standards.... [T]he DOL expects 'compliance with the Impartial Conduct Standards between June 9, 2017 and January 1, 2018, will be substantial, even if there is some reduction in compliance relative to the baseline.' However, the DOL 'is uncertain about the magnitude of this reduction and will consider this line of questions as part of its review'." (Alston & Bird, LLP, via Employers Council on Flexible Compensation [ECFC])
Replacing ACA? Hard. Keeping HSAs? No Problem.
"The AHCA eliminates some of the provisions in the ACA that adversely affected HSAs. For example, the ACA placed a restriction on reimbursing over-the-counter drugs by an HSA; the AHCA eliminates that restriction. The AHCA rolls back the tax for HSA distributions not used for qualified medical expenses to 10%, which were previously 20% under ACA. In addition to repealing provisions of the ACA that adversely affected HSAs, the AHCA adds new provisions that will increase the attractiveness of having a high deductible health plan and contributing to an HSA." (Bill Sweetnam, via Employee Benefit Adviser)
Tear Down the Silos Between HSAs and 401(k)s
"HSAs have triple tax advantages. While funds contributed to either an HSA or a traditional 401(k) are excluded from income taxes, HSA contributions, up to annual limits, are also excluded from FICA and FUTA payroll taxes.... [If] you save your health care receipts in a file today, then during retirement you can withdraw HSA funds tax-free against those years-old receipts, which can turn the HSAs into a fund to pay for more than just future health care expenses." (Society for Human Resource Management [SHRM])
HSA Questions for Employers to Consider
"[1] Investment threshold.... [2] Who chooses the investment lineup? ... [3] What should be the risk profile of the HSA investment lineup? ... [4] What is the risk and reward of offering the option of a self-directed brokerage? ... [6] Does it make sense to mirror the investments in the HSA with that of the company's 401k?" (401K Specialist)
Fiduciary Reforms Will Impact Expanding HSA Market
"[T]he jury is actually still out regarding the question of whether the employers will become fiduciaries to their HSA-using employees. Advisers making investment recommendations for individuals using HSAs will likely take on some new level of fiduciary responsibility ... but as it pertains to an employer's own fiduciary exposure, [the] consensus within the industry is that the new regulations 'probably do not automatically require employers offering HSA plans to be considered fiduciaries.' " (planadviser)
Healthcare Reform Makes HSA Education Imperative
"401(k)s shifted retirement savings responsibility to the consumer, and Republicans hope to do the same for healthcare via HSAs. The shift from pensions to 401(k)s, however, was far from smooth sailing.... How do we avoid the same fate as we prepare for a widespread move to HSAs? Education will be critical from the outset. It is our industry's fiduciary and moral responsibility to educate consumers on the cost of healthcare, and how HSAs can lessen their burden." (Manning & Napier)
HSA Enrollment Rises but Misunderstanding Still Common
Article summarizes three recent -- and sometimes conflicting -- surveys of HSA/CDHP popularity, enrollment, contributions and design. (Society for Human Resource Management [SHRM])
Telemedicine: Proceed With Caution
"Employers who adopt a telemedicine program alongside a high-deductible health plan (HDHP) need to be sure they do not inadvertently disqualify their covered employees from HSA eligibility.... Employers offering access to a telemedicine program to all employees regardless of group health plan enrollment could inadvertently create a separate ERISA group health plan." (Fisher Phillips)
Health Savings Accounts Continue Rapid Growth
"People saving in HSAs do not do so at the expense of a defined contribution (DC) retirement plan, such as a 401(k). Fidelity found that during 2016, people who had both DC and HSA accounts saved on average 10.7 percent of their annual income in the retirement account. Those with just a DC account saved on average 8.2 percent in it.... Seventy-six percent are satisfied with the ease of using their HSA for medical expenses, 77 percent with the quality of their health care coverage, and 77 percent with how the plan helps them manage their health care costs." (Fidelity)
Survey Finds Healthy Trends in HSA Offerings, Enrollments
"35.1% of all plans offer a health savings account (HSA) or a health reimbursement arrangement (HRA), though that's up only slightly from the 34% who did in 2015. However, an HSA is offered in a quarter (24.6%) of plans, a 21.8% increase from five years ago ... HSA enrollment stands at 17%, up 25.9% from 2015 -- and nearly 140% from five years ago. The average employer contribution to an HSA is $474 for a single employee (down 3.5% from 2015 and 17.6% from five years ago) and $801 for a family (down 9.2% from last year and 13.7% from five years ago)." (National Association of Plan Advisors [NAPA])
FSA, HRA, and HSA Comparison Chart (PDF)
Chart summarizes 26 aspects of the programs, including eligibility, portability, discrimination rules, funding requirements, maximum contribution levels, and balance carry-overs. (Marsh Consulting Group)
How Health Savings Accounts Measure Up
"An HSA is offered in 24.6 percent of plans, a 21.8 percent increase from five years ago. HSA enrollment is at 17 percent, a 25.9 percent increase from 2015, and nearly a 140 percent increase from five years ago. The average employer contribution to an HSA is $474 for a single employee (down 3.5 percent from 2015 and 17.6 percent from five years ago) and $801 for a family (down 9.2 percent from last year and 13.7 percent from five years ago)." (United Benefit Advisors)
House Version of Repeal-and-Replace Health Bill Would Make Significant Changes to HSAs
"[T]he AHCA would [1] increase annual HSA contribution limits to equal the maximum HDHP out-of-pocket payment amounts ... [2] treat an HSA as having been established on the date HDHP coverage begins if the HSA is established within 60 days of such date.... [3] restore the 10 percent additional penalty tax on HSA distributions that are not used for qualified medical expenses ... [4] allow spouses that are both eligible to make catch-up contributions to choose which of their HSAs will receive the additional contributions; and [5] allow over-the-counter (i.e., nonprescription) medications to be considered HSA-eligible expenses." (Ascensus)
[Official Guidance] Text of IRS Rev. Proc. 2017-37: 2018 Inflation Adjusted Amounts for Health Savings Accounts (HSAs) (PDF)
"For calendar year 2018, the annual limitation on deductions ... for an individual with self-only coverage under a high deductible health plan is $3,450. For calendar year 2018, the annual limitation on deductions ... for an individual with family coverage under a high deductible health plan is $6,900. For calendar year 2018, a 'high deductible health plan' is defined ... as a health plan with an annual deductible that is not less than $1,350 for self-only coverage or $2,700 for family coverage, and the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $6,650 for self-only coverage or $13,300 for family coverage." (Internal Revenue Service [IRS])
Employers Support HSAs as a Benefits Strategy
"Nearly 60% of the respondents believe HSAs should replace flexible spending accounts (FSAs), and nearly three-fourths of employers think HSAs should be open to all employees, not just those enrolled in a high-deductible health plan (HDHP).... The average HSA account balance was $3,161. A little more than 40% of respondents indicate that 25% or fewer of their participants use up the entire HSA balance every year and an additional 35% of plans state that 26% to 50% of their participants use their entire balance every year.... Only 21% of surveyed employers are concerned about the fiduciary liability of sponsoring a HSA-HDHP." (planadviser)
Health Savings Accounts (HSAs) and How They Intersect with Defined Contribution Plans: Survey Results
11 pages. "The majority (75.3 percent) of employers view the HSA as part of their retirement benefits strategy. Nearly 60 percent of employers believe HSAs should replace Flexible Spending Accounts (FSAs), and nearly three-fourths of employers think that HSAs should be open to all employees, not just those enrolled in a high-deductible health plan." (Plan Sponsor Council of America [PSCA])
Employees Still Can't Find Out How Much Health Providers Charge
"More Americans are enrolling in high-deductible health plans, which means they'll pay more out of pocket for 'commodity' health services -- whether lab tests or common surgeries such as hip and knee replacements. They can shop around for high-quality providers that charge less, but they are finding it difficult to do so." (Society for Human Resource Management [SHRM])
HSAs are Poised for the Spotlight in the Trump Era
"Although the AHCA's initial failure led to uncertainty on the specifics of health care reform, there appears to be a broad push to increase the use of [HSAs]. Various proposals have included plans to remove the requirement to have a high-deductible health plan in order to contribute to an HSA, raise contribution limits to $6,550 for individuals and $13,100 for families (from their current limits of $3,400 and $6,750, respectively), and to create a new type of account called a Roth HSA." (Manning & Napier)
HSA Plans and Onsite Clinics: Can This Marriage Be Saved?
"Under rules for HSA-eligible plans, only preventive services can be provided at no cost; employees need to pay the full cost of a non-preventive visit before they satisfy the plan deductible. Some employers with onsite clinics may be unknowingly disqualifying employees, understating their own tax liability, and incorrectly filing employment tax forms." (Mercer/Signal: US Health News )
Health Savings Accounts: Can They Work for Everyone? (PDF)
"More than half (53%) of all large employers offer an HSA-eligible plan, but under a fourth (24%) of covered employees are enrolled in one.... Despite the cost savings, for the most part large employers still offer these plans as a choice, rather than as the only medical plan. Just 6% of all large employers offer an HSA-eligible plan as a 'full replacement' of their traditional medical plan." (Mercer)
What is a Limited Purpose FSA, and How Can Account Holders Use It?
"A limited purpose FSA (LPFSA) is a healthcare spending account that can only be used for eligible vision and dental expenses. Unlike a healthcare FSA, however, an LPFSA can be held at the same time as [an HSA]. When coordinated with an HSA, the LPFSA can further reduce your taxes while allowing you to allocate HSA funds to other purposes -- including retirement." (DataPath)
Can HSAs Work for Everyone? (PDF)
"The average per-employee cost of HSA-eligible plans is 13% less than that of a traditional PPO.... Despite the cost savings, for the most part large employers still offer these plans as a choice, rather than as the only medical plan. Just 6% of all large employers offer an HSA-eligible plan as a 'full replacement' of their traditional medical plan.... Although full-replacement HSA plans cost more than those offered as a choice, when you compare total health plan cost per employee -- across all medical plans offered -- employers offering full replacement HSA-eligible plans spend much less." (Mercer)
Cash Allowances for Employees to Select from Benefits Suite?
"Generally, if an employer wants to pay its employees a cash allowance that is earmarked for certain benefits, the arrangement has to qualify under one of the plans the IRS has established (e.g. HRA, FSA, HSA, cafeteria plan).... [T]he cafeteria plan rules were set up to accommodate a 'bucket' approach, but employers must comply with the IRS's requirements when setting up such a plan. The money in a full flex plan, that allows employees to choose and trade off among different benefits, can come from employer or employee contributions." (HR Daily Advisor)
What You Should Know Before You Name an HSA Beneficiary
"If you name your spouse as your HSA beneficiary, at your death the HSA will become your spouse's own HSA.... Distributions for qualified medical expenses will be income tax free.... [N]on-spouse HSA beneficiaries do not fare very well! The account value of the HSA account becomes taxable to the non-spouse beneficiary in the year of your death. That means the entire account will be taxable in one year." (Slott Report)
[Opinion] House Obamacare Repeal Bill Limits HSAs for Millions of Americans
"The House Republican American Health Care Act Managers Amendment would not allow Americans to use their tax credits to fund an HSA. Instead of using their tax credit/HSA to pay for doctor visits, prescriptions and OTC drugs, Americans will only be allowed to use their credit for insurance. This is a big mistake -- and a giveaway to insurers." (National Center for Policy Analysis Health Policy Blog)
Companies Behind Health Savings Accounts Could Bank on Big Profits Under GOP Plan
"Industry officials are eager to reach new markets, including baby boomers in Medicare and enrollees in the military's Tricare system, for whom -- under current law -- HSAs are off-limits. They also want to manage larger accounts that generate more revenue. Republican proposals in Congress could help accomplish both." (Kaiser Health News)

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