HRAs, HSAs, and Health FSAs – What’s the Difference? | Employee Benefits Illinois

By Danielle Capilla
Chief Compliance Officer at United Benefit Advisors


Health reimbursement arrangements (HRAs), health savings accounts (HSAs) and health care flexible spending accounts (HFSAs) are generally referred to as account-based plans. That is because each participant has their own account, at least for bookkeeping purposes. Under the tax rules, amounts may be contributed to these accounts (with certain restrictions) and used for health care on a tax-favored basis.

The Patient Protection and Affordable Care Act (PPACA) has added new requirements that affect HRAs and HFSAs. Most HFSAs and HRAs will need to be amended to meet the new PPACA requirements. HSAs generally are not affected by PPACA.

The chart below describes the main characteristics of these types of accounts.


To help determine the best option for your particular situation, request the UBA PPACA Advisor, “HRAs, HSAs, and Health FSAs – What’s the Difference?” for a comprehensive chart comparing eligibility criteria, contribution rules, reimbursement rules, reporting requirements, privacy requirements, applicable fees, non-discrimination rules and other characteristics of these types of accounts.

UBA’s Health Plan Survey analyzes a wide range of health care costs trends. To read the full press release announcing the latest findings related to HSA funding, click here. For all the latest health plan cost trends, download the UBA Health Plan Survey Executive Summary. To benchmark your plan to others in your region, industry or size bracket, contact a UBA Partner near you to run a custom benchmarking report.

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