Account Compatibility Matrix
| Account Combination | HSA Compatible? | Notes |
|---|---|---|
| HDHP + HSA + general-purpose HRA | No | HRA disqualifies HSA |
| HDHP + HSA + limited-purpose HRA | Yes | HRA covers only dental/vision/preventive |
| HDHP + HSA + post-deductible HRA | Yes | HRA pays only after HDHP deductible |
| HDHP + HSA + general-purpose FSA | No | FSA disqualifies HSA |
| HDHP + HSA + limited-purpose FSA | Yes | FSA covers only dental/vision/preventive |
| HDHP + HSA + dependent care FSA | Yes | Dependent care FSA does not affect HSA eligibility |
Designing Compatible Account Combinations
Employers who want to offer both an HSA and an HRA or FSA must carefully design each account to maintain compatibility. The most common approach: offer a limited-purpose FSA alongside the HDHP/HSA, covering only dental, vision, and preventive care expenses. This allows employees to use pre-tax dollars for dental and vision expenses while maintaining HSA eligibility.
Common Compatibility Errors
Watch Out
Common compatibility errors: (1) Offering a general-purpose HRA alongside an HDHP/HSA — the HRA disqualifies HSA contributions; (2) Allowing employees to carry over a general-purpose FSA balance into a year when they are enrolled in an HDHP/HSA — the carryover disqualifies HSA contributions; (3) Allowing a spouse's general-purpose FSA to disqualify the employee's HSA contributions. Review your account design annually for compatibility errors.