Resources on Flexible Spending Arrangements (FSA), Health Reimbursement Arrangements (HRA), and Health Savings Accounts (HSA)

There are a number of tax-favored accounts that are utilized in the design of employer-sponsored health plans. These accounts allow employers to design programs that achieve their benefits program goals on a tax-favored basis to both the employer and the employee, including payroll tax savings for both; and employee income tax savings for both employer and employee contributions. This overview includes the three types of accounts most often encountered in group health plan design by governmental entities: Flexible Spending Arrangements (FSA), Health Reimbursement Arrangements (HRA), and Health Savings Accounts (HSA). It should be noted that additional types of accounts such as Retiree Health Savings Accounts (RHSA), Archer Medical Savings Accounts (Archer MSA), Voluntary Employee Beneficiary Association (VEBA), and Individual Coverage Health Reimbursement Arrangement (ICHRA), are available but less frequently used so not covered in this document.

• Publication date: May 2024