"Plan sponsors with HDHP deductibles below the new minimums of $1,600 for self-only and $3,200 for family coverage will need to increase those deductibles in 2024. While the OOP maximums have increased for 2024, they are still below the maximum limits on cost sharing allowed in 2024 under the [ACA] of $9,450 for self-only and $18,900 for family coverage."

"With inflation still at high levels, we will have a second consecutive year of unusually large increases to the HSA contribution limits."

"All of the dollar limits currently in effect for 2023 will change for 2024, with the exception of one limit. The HSA catch-up contribution for individuals ages 55 and older will not change as it is not subject to cost-of-living adjustments."

"For calendar year 2023, the annual limitation on deductions under Section 223(b)(2)(A) for an individual with self-only coverage under a high deductible health plan is $4,150. For calendar year 2023, the annual limitation on deductions under Section 223(b)(2)(B) for an individual with family coverage under a high deductible health plan is $8,300....

'For calendar year 2023, a 'high deductible health plan' is defined under Section 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,600 for self-only coverage or $3,200 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $8,050 for self-only coverage or $16,100 for family coverage....

For plan years beginning in 2023, the maximum amount that may be made newly available for the plan year for an excepted benefit HRA under Section 54.9831-1(c)(3)(viii) is $2,100."

"[I]ndividuals covered by an HDHP may continue to contribute to an HSA following the end of the PHE. COVID-19 vaccinations also continue to be considered preventive care under Section 223 of the Code for purposes of determining whether a health plan is an HDHP."

"[1] Don't forgo clinical services.... [2] Take steps to manage anxiety.... [3] Improve sleep.... [4] Explore complementary approaches.... [5] Try pressure therapy."

"Proper plan sponsor HSA use requires employee participation to be voluntary, although employers may use automatic enrollment; employers cannot limit the ability of employees to transfer assets to different HSA administrators; employers cannot limit the use of HSA funds or withdrawals; employers cannot influence employees' HSA investment decisions; and employers must offer a reasonable availability of investment options,"

"Health savings accounts are growing in use and popularity as an employee benefit. With advantages both in health care spending and long-term retirement savings, employers can present the benefit in multiple ways."

"[T]he majority (62 percent) of health savings account (HSA) accountholders reported that they are using the account to pay for out-of-pocket expenses. And most (69 percent) viewed the HSA as a savings account. However, 24 percent of HSA accountholders reported using their account to invest in stocks, bonds, or mutual funds. One-third (32 percent) viewed the account as an investment account."

"Programs to treat a drug-related substance use disorder, programs to treat an alcohol use disorder, and smoking cessation programs qualify as medical care because the programs are considered treatment for a disease. However, therapy, nutritional counseling, and weight-loss programs will only be considered medical care if used to treat a specific disease (e.g. obesity). Programs for general health or wellbeing will not qualify as medical care."

"[P]lan sponsors [should] pay particular attention to notifying employees of the upcoming changes that will accompany the end of the PHE and NE and to ensure that participants covered under an HDHP understand that they may continue to contribute to their HSAs."

"In what is a welcome surprise, the FAQs confirm that individuals covered by a High-Deductible Health Plan (HDHP) will remain Health Savings Account (HSA)-eligible until further notice even if the HDHP in which they are enrolled provides medical care services and items purchased related to testing for and treatment of COVID-19 prior to the satisfaction of the HDHP's applicable minimum deductible."

"These Sec. 213 FAQs clarify what medical services and products qualify for deduction or reimbursement. Overall, a physician's prescription or recommendation for a particular medical service or product will be a significant factor in determining whether an employee may deduct or reimburse an expense using tax savings accounts. The same applies to medical services or products treating a physician-diagnosed disease."

"These FAQs do not break new ground or include any surprises. However, they may be helpful to those on the 'front lines' of cafeteria plan administration, who are sometimes asked to explain the reasons for plan operating rules and decisions. They also remind administrators of the importance of obtaining adequate and appropriate substantiation before reimbursing claims and highlight the challenges involved with certain expenses."

"The IRS has issued a series of Frequently Asked Questions (FAQs) to provide guidance as to whether certain costs related to nutrition, wellness, and general health are medical expenses that may be paid or reimbursed on a tax-exempt basis under a group health plan, health savings account (HSA), health flexible spending arrangement (FSA), or health reimbursement arrangement (HRA)."

"Most employees do not treat HSAs as long-term savings and instead use their HSAs to pay for current health care expenses with before-tax dollars.... Employees with greater financial literacy and liquidity are more likely to treat their HSAs as savings, but even most of this group does not. Employees tend to discount employer HSA deposits relative to cash and do not view HSA dollars as fungible with lower health insurance premiums."

"These frequently asked questions (FAQs) address whether certain costs related to nutrition, wellness, and general health are medical expenses under section 213 of the Internal Revenue Code (Code) that may be paid or reimbursed under a health savings account (HSA), health flexible spending arrangement (FSA), Archer medical savings account (Archer MSA), or health reimbursement arrangement (HRA).... Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body.... Medical expenses must be primarily to alleviate or prevent a physical or mental disability or illness. They don't include expenses that are merely beneficial to general health."

"[M]ost accountholders use their HSAs to pay for current expenses ... The average accountholder has a modest balance, contributes far less than the maximum and does not invest their HSA. However, the longer someone owned an HSA, their balance tends to be larger, contributions tend to be higher, and they are more likely they are to invest their HSA in assets other than cash."

"The triple-tax advantaged of Health Savings Accounts make them an ideal savings and investment tool for retirement. In [this article's] examples, the balance from each HSA account portfolio would be available for the account holder to use penalty free and tax free for qualified medical expenses at any time. Health Savings Accounts ... are only available in partnership with an HDHP[.]"

"This provision allows health savings account (HSA)-qualifying high-deductible health plans (HDHPs) to cover telehealth and other remote-care services on a pre-deductible basis. Additionally, an individual otherwise eligible for an HSA can receive pre-deductible coverage for telehealth and other remote-care services from a stand-alone vendor outside of the HDHP.... Likewise, the spending bill extends Medicare telehealth provisions for another two years. "

"For use in preparing 2022 returns.... What's New: [1] Telehealth and other remote care services.... [2] Health FSA contribution and carryover for 2023.... [3] Insulin products.... [4] Health FSA contribution and carryover for 2022.... [5] Home testing for COVID-19 and personal protective equipment for preventing spread of COVID-19... [6] Surprise billing for emergency services or air ambulance services."

"HDHPs can continue to offer first-dollar coverage for telehealth and other remote care services while preserving participants' eligibility for health savings account ('HSA') contributions. The two-year extension continues the relief until January 1, 2025."

"Despite a rebound in out-of-pocket health care spending in 2021, HSA balances increased on average over the course of the year.... Accounts that received an employer contribution saw higher total contributions and were more likely to invest.... Most accountholders took a distribution in 2021.... Age and tenure play a major role in HSA utilization."

"Mercer projects the 2024 inflation-adjusted amounts for health savings accounts (HSAs), high-deductible health plans (HDHPs) and excepted-benefit health reimbursement arrangements (HRAs) will rise significantly from 2023 levels.... [A table] shows the projected HSA, HDHP and excepted-benefit HRA amounts for 2024, along with the 2023 and 2022 values for comparison."

"The 2023 CAA telehealth relief is optional. Employers may, but do not have to, provide telehealth and other remote care services on a pre-deductible basis. However, employers that choose not to provide telehealth on a pre-deductible basis still must comply with FFCRA which ... requires group health plans to cover ... certain COVID-19 diagnostic tests and related services provided during telehealth visits until the end of the Public Health Emergency."