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Plan Comparison Chart

Comparing flex plans can be confusing. This chart will help you identify the best option that works for your situation.
FSA HRA HSA
Do contributions reduce annual tax expenses for the contributor? Yes No Yes
Is this owned by the account holder? No No Yes
Is this owned by the employer? Yes Yes No
Can the account holder contribute? Yes No Yes
Can the employer contribute? Yes Yes Yes
Does the account stay with the account holder if they retire/change jobs? No No Yes
Do unused balances roll over from year to year? No Determined by the employer. Yes
What is the annual contribution limit? $2,500 (2013)/$5,000 for dependent care. Determined by the employer. $3,100 for individuals/ $6,250 for families (2012).
What medical expenses are eligible for reimbursement? Code 213(d) medical expenses incurred during coverage period that would otherwise go unreimbursed; does not include insurance premiums or long-term care services. Code 213(d) medical expenses incurred during coverage period that would otherwise go unreimbursed; includes premiums for eligible insurances for employee/spouse/dependents, (subject to designated employer limitations). Code 213(d) medical expenses of account holder/spouse/dependents incurred after HSA established; does not include premiums (with limited exceptions).

HSA’s can reimburse the following premiums:

  • Premiums for qualified long-term care insurance
  • Premiums for COBRA health care continuation coverage
  • Premiums for health coverage while an individual is receiving unemployment compensation
  • For individuals over age 65, premiums for Medicare Part A or B, a Medicare HMO and the employee share of premiums for employer-sponsored health insurance, including premiums for employer-sponsored retiree health insurance. Premiums for Medigap policies are not qualified medical expenses.
Are distributions for non-medical expenses permitted? No No Yes, distributions cannot be restricted to just medical expenses; however, distributions for non-medical expenses are taxable and subject to a 20% excise tax.
Are self-employed individuals eligible to have an account? No No Yes, but they will not be eligible to participate in a cafeteria plan used to fund HSAs in the workplace.
Can amounts that are unused at termination of employment continue to be spent down? No Yes, can be used until depleted, if allowed by employer’s plan. Yes, non-forfeitable and portable account type.
Is expense substantiation required? Yes Yes Yes, HSA account holder must retain records but may not be asked to substantiate all expenses.
Is claims adjudication required? Yes Yes No
Can an individual participate in more than one of these accounts at the same time? Yes An employee with an FSA may participate in an HRA. An employee with a Limited Purpose or Post Deductible FSA can participate in an HSA, (a traditional FSA would make an employee ineligible for an HSA). Yes An employee with an HRA may participate in an FSA. An employee with a Limited Purpose/High Deductible/Suspended or Retirement HRA can participate in an HSA, (a traditional HRA would make an employee ineligible for an HSA). Yes An employee with a Limited Purpose or High Deductible FSA or HRA, and a Deductible or Retirement HRA can participate in an HSA, (a traditional FSA or HRA would make an employee ineligible for an HSA).
Is this an ERISA plan? Yes, unless maintained by a church or governmental entity. Yes, unless maintained by a church or governmental entity. Usually no, unless an employer's action triggers ERISA under DOL guidance.
Is an ERISA Form 5500 required to be filed? Yes, with the exception of plans with fewer than 100 participants. Yes, with the exception of plans with fewer than 100 participants. No
Do ERISA SPD and other disclosures and adherence to ERISA's benefit claims procedures apply? Yes Yes No
Does COBRA apply? Yes Yes Generally no.