Government Information on Health Savings Accounts


Listed below are links to websites and publications from the Congressional Record, the U.S. Department of Treasury, and the Internal Revenue Service, detailing all aspects of how Health Savings Accounts work and IRS rules that govern them.  You may also be interested in viewing our information on state income tax treatment.

U.S. Congressional Record

  • Medicare Prescription Drug, Improvement, and Modernization Act of 2003 , Public Law 108-173 that established Health Savings Accounts.
  • The Tax Relief and Healthcare Act of 2006 , HR6111 has many provisions that make it easier to open and fund an HSA, including a one-time transfer from an IRA, expanded contribution limits, and rollovers from HRAs and FSAs.
  • The Patient Protection and Affordable Care Act , Public Law 111-148, also known as the Health Care Reform law, makes numerous changes to how health care works in the United States. Of particular interest to HSA owners:

    • New plans will be required to cover preventive services with no deductible or copay.  This does not affect "grandfathered" plans already in force.
    • Non-prescription medication is no longer considered a qualified medical expense after January 1, 2011.
    • The penalty for withdrawals from an HSA for non-medical expenses increases from 10% to 20% after January 1, 2011.
    • Starting in 2014, plans will have a minimum actuarial value requirement, which may make high deductible plans no longer available.

U.S. Department of the Treasury

Internal Revenue Service Publications

Qualified Medical Expenses

  • U.S. Internal Revenue Service publication 502  gives a fairly detailed list of qualified medical expenses.
  • Qualified medical expenditures are governed under IRS code 213 (d).

IRS Updates

  • IRS Bulletin – October 28, 2008 - IRS Notice 2008-73-209 - Employer Comparable Contributions to Health Savings Accounts Under Section 4980G, and Requirement of Return for Filing of the Excise Tax Under Section 4980B, 4980D, 4980E or 4980G; Hearing.
  • IRS Bulletin – June 27, 2008 - IRS Notice 2008-59 - Notice 2008-59 contains more than 40 new frequently asked questions and answers that cover a wide range of topics, including: Who is an Eligible Individual, Issues related to High Deductible Health Plans, Contributions to Health Savings Accounts, Distributions from Health Savings Accounts, and Establishing an HSA.
  • IRS Bulletin – June 9, 2008 - IRS Notice 2008-51 - Under these new rules, individuals covered by a HDHP that also own a traditional or Roth IRA can make a one-time IRA-to-HSA funding transfer without facing federal income taxes or penalties.  The transfer amount cannot exceed the individual's maximum HSA contribution limit.
  • Federal Register – April 17, 2008 - Employer Comparable Contributions to Health Savings Accounts Under Section 4980G.  These regulations concern how employers comply with comparable contribution requirements for Health Savings Accounts, employees that do not establish an HSA by the end of the year, or an employee who has neglected to tell the employer that he or she has established an HSA.  Also covered is instances when an employer accelerates contributions for the calendar year for employees who have incurred qualified medical expenses.  These regulations went into effect April 17, 2008, and apply to employer contributions made for calendar years beginning on or after January 1, 2009.
  • Internal Revenue Bulletin – October 2, 2006 - Announcement 2006-72 provides final regulations to clarify employer comparable contributions to an HSA.  The new regulations give employers additional flexibility in their plan design for employees without failing the comparability rules.  The following points were included in the news release:

    • Employees covered by a collective bargaining agreement between the employee representatives and employer are excused from the comparable contribution rules.
    • Employers can make different contributions depending on the varying type of family coverage (self plus one, self plus two, self plus three or more).
    • Further clarification on cafeteria plan contributions.  Employees contributing through a salary reduction with a cafeteria plan will be excluded from the comparability rules.
  • IRS Update – July 7, 2006   - 26 CFR, Part 54 contains final regulations that provide guidance regarding employer comparable contributions to Health Savings Accounts.  In general, these final regulations affect employers that contribute to employees’ Health Savings Accounts.  The final regulations state that when an employer makes a contribution to an employee's health savings account, they must contribute a comparable amount to all employees who are eligible.
  • IRS Bulletin – January 17, 2006  - Announcement 2006-4 contains a notice of public hearing on proposed regulations providing guidance on employer comparable contributions to Health Savings Accounts under section 4980G.
  • IRS Bulletin – December 5, 2005  - Bulletin 2005-49 provides relief for certain health plans with non-calendar year renewal dates that otherwise qualify as high-deductible health plans (HDHPs), except that the plans provide state-mandated benefits without regard to a deductible or with a deductible below the minimum annual deductible.
  • IRS Update – November 24, 2005  - Notice 2005-86 provides guidance on how to coordinate Health Savings Accounts with FSAs with the 2½ month FSA account spending extension.
  • IRS Update – November 17, 2005  - Notice 2005-83 extends the transition relief for certain plans that have deductibles that are not timed to the calendar year with non-conforming state-mandated benefits.
  • RS Bulletin – October 11, 2005  - Bulletin 2005-41 provides guidance on employer comparable contributions to Health Savings Accounts under section 4980G.  In general, these proposed regulations would affect employers that contribute to employees’ Health Savings Accounts.
  • IRS Update – April 13, 2005 - Notice 2005-25 explains that an individual can set up a Health Savings Account even if his or her spouse has a non-qualifying health insurance plan, as long as the individual setting up the HSA is not covered by that plan.
  • IRS Update – January 14, 2005  - Notice 2005-8 explains how the Internal Revenue Service will be applying deductibility provisions for a partnership’s contributions to a partner’s Health Savings Account (HSA), and an S corporation’s contribution to a 2-percent shareholder-employee’s HSA.
  • IRS Update July 23, 2004 - Notice 2004-50 consists of 88 questions and answers, including rules for dealing with errors, and information on permissible investments for Health Savings Accounts.
  • IRS Update May 11, 2004  - Notice 2004-45 clarifies how health Flexible Spending Arrangements (FSAs) and Health Reimbursement Arrangements (HRAs) interact with Health Savings Accounts (HSAs).  In particular, this ruling states that eligible individuals (who of course must be covered by a high deductible health plan (HDHP)) may still contribute to an HSA while also covered by the following types of employer-provided plans that reimburse employee medical expenses:

    • Limited purpose FSAs and HRAs that restrict reimbursements to certain permitted benefits such as vision, dental, or preventive care benefits.
    • Suspended HRAs where the employee has elected to forgo health reimbursements for the coverage period.
    • Post-deductible FSAs or HRAs that only provide reimbursements after the minimum annual deductible has been satisfied.
    • Retirement HRAs that only provide reimbursements after an employee retires.
  • IRS Update - April 12, 2004 - Notice 2004-23 allows preventive care benefits to be provided by a high deductible health plan (HDHP) without having to satisfy the minimum deductible.
  • IRS Update - January 12, 2004 - Notice 2004-2 provides basic guidance on health savings accounts.
  • IRS Update - September 3, 2003 - Revenue Ruling 2003-102 that over-the-counter drugs and medicines can be paid for from an HSA or HRA.
  • U.S. Treasury Release: The Basics of Health Savings Accounts

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