HRA vs HSA vs FSA Comparison Chart

Comparison charts provide an excellent way of summarizing complex information. For those interested in defined contribution health strategies, you may be interested in comparing various benefits vehicles.

This comparison chart examines the health reimbursement arrangement (HRA), health savings account (HSA), and flexible spending account (FSA).

It's a good summary of the key differences between the four primary types of health care reimbursement accounts and arrangements.

What do HRA, HSA, and FSA Stand for?

HRA = Health Reimbursement Arrangement. For the purposes of this blog, we will be examining the qualified small employer health reimbursement arrangement (QSEHRA)

HSA = Health Savings Account

FSA = Flexible Spending Account

HRA, HSA, and FSA Feature Comparison Chart

	HRA	HSA	FSA
Who may Contribute	Employer Only	Employer or Employee	Employee or Employer
Cost of Employer Contributions	Only pay for Utilization (typically 25-50%)	100% paid regardless of Utilization	n/a
Average Cost to Cover $2,000/year Deductible	$500–1,000	$2,000	$2,000
Maximum Annual Contribution	$5,150 (single), $10,450 (family) for 2019	$3,500 (single), $7,000 (family) for 2019	Determined by Employer; Capped at $2,600, including employee contributions, in 2017
Eligibility Requirements	Must have minimum essential coverage to receive reimbursements tax-free	Must have HSA-qualified health coverage	None or Determined by Employer
Each Employee must open new Bank Account?	No	Yes	No
Tax Treatment	Tax-free	Tax-free	Tax-free
Medical Expenses Allowed	Health Insurance Premiums + IRC 213(d)	IRC 213(d) Expenses w/ No Employer Limitations	IRC 213(d) Expenses; but no Personal Health Insurance
Use for Non-Medical Expenses	None	None	None
Carryover of unused funds to next year	No	Yes	No
Portable after Termination	No	Yes	No
Administrator	Employer or TPA	Employee	Employer or TPA
Cross-Compatibility	QSEHRA with HSA* or FSA>	Limited-Purpose or Post-Deductible FSA or HRA	With HRA or HSA*
Employer Reporting	Employer Views Detailed Utilization Reports	No Tracking Possible	Employer Views Detailed Utilization Reports