"This report summarizes the principal rules governing HSAs, covering such matters as eligibility, qualifying health insurance, contributions, withdrawals, and tax advantages. It concludes with a discussion of HSA data limitations and recent trends in HDHP enrollment and HSA utilization. It includes HSA-related changes in the fiscal year (FY) 2025 budget reconciliation law sometimes referred to as the One Big Beautiful Bill Act[.]" [R45277 updated Feb. 23, 2026] MORE >>
"HSAs are increasingly operating like powerful long-term investment vehicles rather than just spending accounts. Yet misconceptions persist across the workforce, and employee education continues to lag.... [This article examines] the triple tax advantages, workforce perception trends, and evidence-based insights to guide employers in maximizing HSA participation and value." MORE >>
22 pages. "What's new: [1] Telehealth and other remote care services.... [2] Health Flexible Spending Arrangement (FSA) contribution and carryover for 2025." MORE >>
23 pages. "What's new: [1] Telehealth and other remote care services.... [2] Health Flexible Spending Arrangement (FSA) contribution and carryover for 2025." MORE >>
"By taking an integrated approach to managing health and retirement programs, employers can unlock meaningful tax efficiencies across health savings accounts (HSAs), flexible spending accounts (FSAs), transportation benefits, and retirement plans like 401(k)s and 403(b)s. The real driver of these savings? Increasing employee participation in tax-advantaged plans." MORE >>
"[T]here are a variety of creative options for employers who want to provide access to GLP-1 drugs prescribed for weight loss but who also want to contain costs. But, as with any benefits program, each employer must carefully consider the associated risks with these options and ensure they can be tailored to suit the employer's individual needs. These options include health reimbursement accounts and health flexible spending accounts." MORE >>
"While much of the guidance confirms existing practice, several provisions are particularly relevant for employers sponsoring HDHPs.... Employers considering offering a [Direct Primary Care Service Arrangement (DPCSA)] should carefully review whether the arrangement meets all statutory requirements to avoid unintentionally disqualifying employees from making HSA contributions." MORE >>
"[Notice 2026-05] links to two websites containing qualifying telehealth services lists ... Employers may need to work with their telehealth provider to determine whether their services are 'consistent with the principles of' Social Security Act section 1834(m).... It is theoretically possible for an employer to structure an onsite clinic offering [direct primary care service arrangements (DPCSA)] membership with items and services provided outside the DPCSA, available to employees who are not DPCSA members, and billed separately.... If a DPCSA arrangement does not meet the Notice requirements, it provides medical care and would be considered disqualifying insurance preventing HSA eligibility." MORE >>
"Employers who continuously adopted the telehealth and other remote care services exception since the COVID relief was effective have been assured that their employees' HSA eligibility is not in question ... Telehealth and other remote care services received prior to the applicable deductible being met should not include any in-person services, medical equipment, or prescription drugs supplied in conjunction with telehealth and other remote care services." MORE >>
Seventeen 2026 compliance guides cover common employee health and welfare benefits issues and strategies for employers, including COBRA, HSAs, domestic partner issues, HIPAA, ICHRA, and more. MORE >>
"OBBBA ... introduced several changes affecting HSAs, including a permanent safe harbor for pre-deductible telehealth and remote care, the designation of [ACA] Exchange bronze and catastrophic plans as HSA-compatible, and clarification that qualifying Direct Primary Care Service Arrangements (DPCSAs) do not disqualify individuals from HSA eligibility." MORE >>
"[T]he new guidance [1] clarifies that the safe harbor does not extend to in-person services, medical equipment, or drugs furnished in connection with telehealth or other remote care services.... [2] clarifies how Direct Primary Care Service Arrangements (DPCSAs) interact with HSAs.... [3] provides that beginning January 1, 2026, bronze and catastrophic health plans, including those obtained through a health insurance exchange, will be treated as HSA-compatible, even if they don't meet the traditional high-deductible requirements." MORE >>
"Effective for the 2025 plan year, OBBBA reinstated and made permanent COVID-19-era telehealth relief allowing HSA-compatible high-deductible health plans (HDHPs) to cover telehealth and other remote care services before the statutory minimum deductible is satisfied. Beginning Jan. 1, 2026, OBBBA also allows individuals enrolled in certain direct primary care service arrangements to remain eligible to make or receive HSA contributions and treats certain bronze and catastrophic plans as HDHPs. This article summarizes provisions of Notice 2026-5 most relevant to employers." MORE >>
"The guidance addresses telehealth services, direct primary care arrangements and individual market coverage. [Notice 2026-5] does not break much new ground, but a few provisions are worth noting. [1] Telehealth safe harbor made permanent ... [2] Direct primary care service arrangements ... [3] Bronze and catastrophic plans." MORE >>
"Plan sponsors should be collaborating with their payroll vendors and recordkeepers to understand how mandatory Roth catch-up contributions will be processed for high wage earners ... [If] at least one applicable retirement plan within a controlled group permits super catch-up contributions, all controlled group retirement plans must also permit super catch-up contributions.... By February 16, 2026, each HIPAA covered entity and business associate must update its Notice of Privacy Practices (NPP) ... Some section 409A corrections under Notice 2008-113 must be completed by year-end, making now the ideal time to identify and finalize correction of any lingering errors." MORE >>
"Previously, enrollment in a direct primary care service arrangement typically disqualified individuals from HSA contributions.... Now, qualifying direct primary care service arrangements (DPCSAs) are no longer treated as health plans for HSA eligibility purposes. This means you can be enrolled in both a high deductible health plan (HDHP) and a qualifying DPCSA while maintaining your ability to contribute to an HSA." MORE >>
"[Notice 2026-5] affirmed a permanent safe harbor provision allowing HSA holders to receive telehealth and other remote care services before meeting their deductible, while remaining eligible to contribute to an HSA, effective for plan years beginning on or after January 1, 2025. The notice also clarified that, as of January 1, 2026, bronze and catastrophic plans available through a health care exchange are considered HSA-compatible, regardless of whether the plans satisfy the general definition of a high-deductible health plan. The plans do not have to be purchased through an exchange to qualify for the relief." MORE >>
"[T]he OBBBA made permanent the safe harbor allowing high-deductible health plans (HDHPs) to cover telehealth and other remote care services before the minimum deductible is satisfied without losing their HDHP status. These services are also considered disregarded coverage on a permanent basis and thus will not cause a loss of HSA eligibility. " MORE >>
"While [Notice 2026-5] provides some helpful clarification, it points the public to other, not very straightforward, sources for determining which telehealth services may be provided ... [It] permits an individual who does not even purchase a bronze or catastrophic plan available through an Exchange to be HSA-eligible, but again, the guidance points the public to other sources to determine whether the rules are satisfied.... [T]he guidance on direct primary care arrangements ... suggests that, except for a narrowly defined arrangement, an individual cannot participate in a direct primary care arrangement and contribute to an HSA at the same time." MORE >>
"Heath savings accounts (HSAs) are proving to be a way for many employers and employees to better control health care costs, thanks to their tax benefits, lower premiums, and long-term investment opportunities. Learn how to drive greater participation throughout the plan year." MORE >>
"Under the bill, individuals who sign up for a bronze or catastrophic plan on the exchanges that's paired with an HSA will receive a contribution from the Centers for Medicare & Medicaid Services. For individuals making up to 700% of the federal poverty level, they will receive $1,000 if aged 18 to 49 and $1,500 if they're between the ages of 50 and 64." MORE >>
"What's New: P.L. 119-21, July 4, 2025, amended Code section 223 to provide that: [1] An HSA eligible individual may have disregarded coverage (besides the HDHP) for telehealth and other remote care. [2] A plan will not fail to be treated as a HDHP by reason of failing to have a deductible for telehealth and other remote care services. The amendments apply to plan years beginning after 2024." [Also available: 2025 IRS Form 8889: Health savings Accounts] MORE >>
"[Some] are pitching the accounts as an alternative to expiring enhanced federal subsidies that have lowered insurance premium payments for most Americans with [ACA] coverage. But legal limits on how HSAs can and can't be used are prompting doubts that expanding their use would benefit the predominantly low-income people who rely on ACA plans.... One group that would almost certainly benefit: a slew of companies selling expensive wellness items that can be purchased with tax-free dollars from the accounts." MORE >>
"[T]he Health Savings Account (HSA) Consumer Protection Act [HR 6183] ... [would] [1] Remove the exception that permits HSA use for non-health care services without penalty at age 65.... [2] Place income limitations around the payroll tax exemption for HSA contributions.... [3] Require individuals to substantiate that their distributions from HSAs are for qualified medical expenses.... [4] Ensure that institutions offering HSAs do not charge excessive fees and meet basic transparency requirements[.]" MORE >>
