Comparison of Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)

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1 Account Overview Tax-exempt trust or custodial account created to pay for the qualified medical expenses of the account holder and his/her spouse or dependents. A cafeteria plan authorized under Section 125 of the Internal Revenue Code. Limited Purpose FSAs can be created to reimburse for qualified dental and vision expenses. A cafeteria plan authorized under Section 125 of the Internal Revenue Code. FSAs can be created to reimburse for qualified medical expenses, health insurance premiums for premium-only accounts, or dependent care expenses. Funding Individual and/or an employer. Typically funded by an employee (employer funding is allowed). Typically funded by an employee (employer funding is allowed). Eligibility Individuals and families must be covered by a qualified high-deductible health insurance plan (HDHP). An employee whose employer offers an FSA option. An employee whose employer offers an FSA option. Health Plan Requirements Qualified high-deductible health insurance plan with a minimum annual deductible of $1,300 for an individual and $2,600 for families for WPI s high-deductible plan has a $1,500 / $3,000 deductible. Maximum out-of-pocket limits, including the deductible, are $6,450 for an individual and $12,900 for a family in The HDHP may provide firstdollar coverage for preventive care. No corresponding health plan requirements. No corresponding health plan requirements.

2 Contributions Account holders or an employer or both may contribute to an HSA up to $3,350 for an individual and $6,650 for a family account may be contributed for An employee, employer or both may contribute to an FSA. For limited purpose health care spending accounts (HCSAs) there is an annual limit of $2,500. An employee, employer or both may contribute to an FSA. For health care spending accounts (HCSAs) there is an annual limit of $2,500. For dependent day care accounts (DCAPs) there is an annual limit of $5,000. Catch Up Contributions Participants age 55 and older and not enrolled in Medicare can make a catch up contribution of $1,000. Not applicable. Not applicable.

3 Qualified Medical Expenses Unreimbursed qualified medical expenses as defined in Section 213 (d) of the Internal Revenue Code, e.g., amounts paid for doctors fees, prescriptions drugs, and medically necessary services not paid for by insurance (including many over-thecounter medicines). Qualified expenses also include expenses for dental and eye care expenses. Qualified dental and vision expenses only. Unreimbursed qualified medical expenses as defined in Section 213 (d) of the Internal Revenue Code. OTC reimbursements will be allowed only with medical certification from doctor. Carryover HSA funds may be carried over indefinitely throughout an account holder s lifetime no limits exist to how much can be saved up. Upon death, an account may be passed on to a surviving spouse without federal tax liability. If an employer elects to allow in their FSA plan, Funds may carry over to the following year. The federal limit for carryovers is $500. If an employer does not allow any rollovers in their plan, and the employee does not use all the Funds before the end of the year, the employee will forfeit the leftover balance. If an employer elects to allow in their FSA plan, Funds may carry over to the following year. The federal limit for carryovers is $500. If an employer does not allow any rollovers in their plan, and the employee does not use all the Funds before the end of the year, the employee will forfeit the leftover balance. Portability Employees own the monies in their HSA account and will take it with them when leaving or changing jobs. Funds from an FSA are not portable and employees forfeit unused balances when leaving or changing jobs (unless COBRA is elected health care spending accounts only). Funds from an FSA are not portable and employees forfeit unused balances when leaving or changing jobs (unless COBRA is elected health care spending accounts only).

4 Tax Status Employee contributions are tax deductible; employer contributions are excludable from gross income and are not subject to employment taxes. Employees are not subject to federal, Social Security, or in most states, state taxes on contributions to an FSA. Employers are not subject to FICA or unemployment taxes on FSA contributions. Employees are not subject to federal, Social Security, or in most states, state taxes on contributions to an FSA. Employers are not subject to FICA or unemployment taxes on FSA contributions. Withdrawals Funds not used to pay for qualified medical expenses may be withdrawn but are subject to income taxes and an additional 20% tax penalty, except when an individual is 65 or older, disabled, or has died during the year. Withdrawals for non-medical expenses are not permitted. Withdrawals for non-medical expenses are not permitted. Interest HSA accounts are invested in a fixed income or variable return (mutual funds). Interest does not accrue for FSA funds. Interest does not accrue for FSA funds. Interest accrues income tax-deferred.

5 Health Insurance Premium Payments HSA funds may be used to pay health insurance premiums in the following situations: While an individual receives unemployment insurance; While an individual receives COBRA continuation benefits; or When an individual reaches age 65 for any health insurance except Medicare supplement policies (i.e MediGap or Medex type policies). A separate premium-only plan may be created to pay an employee s contribution toward the monthly cost of health insurance premiums. Under a salary reduction arrangement, the employee agrees to contribute a portion of salary on a pre-tax basis to pay for premiums. A separate premium-only plan may be created to pay an employee s contribution toward the monthly cost of health insurance premiums. Under a salary reduction arrangement, the employee agrees to contribute a portion of salary on a pre-tax basis to pay for premiums. Long Term Care Premiums Funds from an HSA may be used to pay for qualified long-term care insurance premiums, although limits apply as to the amount that can be reimbursed each year based on the employee s age. Long-term care insurance is specifically excluded as a qualified benefit under the IRS code. Long-term care insurance is specifically excluded as a qualified benefit under the IRS code.

6 Are FSAs Allowed To Be Offered Alongside These Plans? Limited Purpose FSAs are allowed to be offered alongside an HSA. Typically, benefits are limited to dental and eye care. Also, other limited types of FSAs or HRAs are allowed, such as Post Deductible Health FSAs or HRAs that do not pay or reimburse any medical expense until the minimum annual deductible under the HDHP is satisfied; Suspended HRAs (pursuant to elections made before the HSA coverage period) that do not pay or reimburse any medical expense (other than preventive care) during the suspension period; and Retirement HRAs that pay or reimburse only those medical expenses after retirement. Limited Purpose FSAs are allowed to be offered alongside an HSA. Typically, benefits are limited to dental and eye care. Not applicable.

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