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Top 9 questions about HSAs answered



In today’s rapidly evolving healthcare landscape, Health Savings Accounts (HSAs) offer a remarkably effective solution to ease the financial strain experienced by employees due to high inflation and the changing nature of health insurance.

But employees — and often employers — have legitimate questions about HSAs. Are you prepared to answer them?

HSAs, when paired with high-deductible health plans (HDHPs), empower employees to save for future medical expenses, while reducing their tax burden. These fully portable accounts, owned by the employees, also serve as a safety net if they leave your organization.

Addressing commonly asked questions and educating your workforce on the potential of HSAs will foster financial and healthcare security and demonstrate your commitment to their overall well-being.

Employer questions about HSAs

Who can open an HSA?

To open an HSA, participants must meet specific criteria:

  1. They must be enrolled in a qualifying HDHP
  2. They cannot be claimed as a dependent on someone else’s tax return or cannot be covered by another health insurance plan that does not qualify as an HDHP, and
  3. If they have already enrolled in Medicare, they are not eligible for an HSA.

What are the benefits of an HSA?

The main benefit of having an HSA is that it allows individuals to save money on a pre-tax basis for qualified medical expenses. This means that the funds deposited into a participant’s account will not be subjected to federal income taxes when it is withdrawn for eligible expenses. Finally, any money left in the owner’s account at the end of the year will roll over into the next year so long as it remains in the account and is not used for non-qualified expenses or distributions before reaching age 65.

How do I ensure my employees are properly informed about their HSA?

To effectively ensure that your employees are well informed about their HSAs, it is vital to adopt a comprehensive communication strategy incorporating various channels to disseminate relevant information. Start by conducting educational sessions and workshops that clarify the benefits, eligibility criteria, contribution limits and tax advantages of an HSA.

Provide them with user-friendly resources such as explanatory videos, infographics and brochures to supplement the training sessions. Encourage open dialogue by scheduling regular check-ins with your employees to address any questions or concerns they may have, and foster a supportive environment that promotes understanding and engagement around this crucial aspect of employee benefits.

Constantly updating your team with any new changes or modifications to the HSA guidelines will foster a culture of transparency and empower your employees to make informed decisions about their healthcare and financial planning.

How can employers help their employees maximize their HSAs? 

Employers can help employees maximize their HSAs by offering them additional benefits such as flexible spending accounts (FSAs). FSAs allow employees to set aside pre-tax money for certain medical expenses without worrying about meeting deductibles or keeping track of receipts. Employers should also educate their employees on what qualifies as an eligible expense so they know exactly which products or services they can purchase with their HSA funds.  

Employee questions about HSAs

What qualifies as an HSA?

To be eligible for an HSA, it is essential to be enrolled in a high-deductible health plan (HDHP), which typically features lower premiums in exchange for higher deductibles and out-of-pocket expenses. By adhering to the guidelines and annual contribution limits established by the IRS, participants can leverage the benefits of an HSA to efficiently allocate their healthcare resources and keep themselves in good financial health.

What sets HSAs apart from other health benefits?

HSAs stand out from other health benefits due to their unique combination of advantageous attributes, encompassing elements of both Flexible Spending Accounts (FSAs) and 401(k) plans. This distinct fusion allows employees to tailor their HSA usage to their needs, thereby addressing their immediate concerns and long-term objectives. A key difference is that employees maintain complete control over their HSA funds, even after leaving a job, unlike other benefit plans such as FSAs.

Additionally, HSAs offer the ease of adjusting contribution amounts without needing major life events, making them more akin to a 401(k) retirement plan. This empowers employees to make informed decisions about which healthcare expenses to cover, allowing them to save or use their balance, for instance, to meet out-of-pocket expenses before reaching their deductible with an HDHP.

Furthermore, HSAs allow employees to invest their balances, opening the door to growing their funds for future medical expenses, including retirement. These features make HSAs a valuable addition to any employee benefits package, encouraging responsible health expense management and financial planning.

How can I use my HSA funds? 

HSAs uniquely provide employees a tax-advantaged way to save and pay for qualified medical expenses. HSA funds can be used to cover a wide range of medical treatments, including doctor visits, prescription medications, dental care, vision services, and even certain over-the-counter items.

Additionally, by investing their HSA funds in diverse portfolios, employees can grow their account balances and reap the long-term benefits of tax-free growth. Ultimately, HSAs present a robust and flexible solution for employees to take charge of their healthcare finances. With proper management, these accounts can be a significant asset in achieving overall financial security.

What are the different types of HSA distributions and how are they treated for tax purposes?

When delving into HSA distributions, it is essential to understand that there are several types, each with its tax implications.


  • Eligible medical expenses
  • Long-term care insurance
  • Health insurance premiums (after the age of 65 or while receiving unemployment compensation)
  • COBRA health insurance premiums, and
  • Rollovers and transfers.

Taxable without penalty:

  • HSA after the age of 65, and
  • Death and disability distributions.

Additional distributions are taxable and subject to a 20% penalty.

Should I be saving my receipts?

As an HSA owner, keeping track of your medical expenses is critical to managing an HSA. It is essential to save receipts for medical expenses paid with an HSA, as these documents are necessary to demonstrate that any expenses were qualified healthcare expenses. Keeping receipts enables participants to validate their spending, reducing the likelihood of paying additional taxes or penalties and ensuring accurate record-keeping for personal and tax purposes.

Overall, HSAs offer both employers and employees significant savings opportunities when it comes to health care costs. Navigating the world of HSAs can be much easier with the proper guidance.

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