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Health Savings Accounts (HSA) - HSAs, or medical savings accounts, are savings accounts created to pay for unreimbursed health care expenses. These accounts can accumulate tax-deferred interest like IRAs. The money is deducted on a pre-tax basis, so it lowers the employee's taxable income and overall taxes paid.

Health Reimbursement Accounts (HRA) - Health Reimbursement Arrangements are employer-funded arrangements that reimburse employees for qualified medical expenses. Employers pay for HRAs entirely. Employees do not contribute to the accounts.

Flexible Savings Accounts (FSA) - FSA is a benefit plan established by an employer to reimburse employees for specific medical expenses. The employee contributes money through an automatic pre-tax salary reduction. Employers may contribute to these accounts as well.

See our chart for more information.

 

Health Savings Account (HSA) Heath Reimbursement Account (HRA) Flexible Savings Account (FSA)
Description Actual bank accounts in employees' names that allow employees to save and pay for medical expenses tax-free. A great way for employer to manage health care costs. With funds contributed by employer, the HRA reimburses employees for qualified medical expenses up to an account balance.These dollars are tax-free for participants. Allow employees to pay out-of-pocket expenses for copays, deductibles and certain services not covered by their medical plan, tax-free. Only option that allows employees to pay for dependent care tax-free.
Employer Eligibility Employee with a qualified high deductible health plan. All employers All employers
Contribution Source Employee and/or employer Employer only Employee or employer but not both
Account Owner Individual Employer Individual
Underlying Insurance Requirement High deductible health plan None None
Minimum Deductible $ 1,110 single (2008)
$ 2,200 family (2008)
No limits N/A
Maximum Contribution $ 2,900 single (2008)
$ 5,800 family (2008)
Typically set by employer Typically set by employer
Permissible Use Of Funds Employees may use funds any way they wish. If used for non-qualified medical expenses, subject to current tax rate plus 10% penalty. Reimbursement for qualified medical expenses (as defined by tax code). Reimbursement for qualified medical expenses (as defined by tax code).
Cash-Outs of Unused Amounts (if no medical expenses) Permitted, but subject to current tax rate plus 10% penalty (penalty waived after age 65). Not permitted Not permitted
Year-to-year rollover of account balance? Yes, may roll over to use for subsequent year's health coverage. Limited (Taxable beyond a defined amount.) No  
Does the account earn interest? Yes No No
Portable? HSA owned by individual: portable year-to-year and between jobs. Limited: Ex-employee may have access at employer's discretion. Employee forfeits balance at end of year and upon termination.
This comparison is intended as a summary only. Please see plan documentation for complete explanation and IRS limitations.
"We have utilized the services of George Koury and Associates for the past eight years for our health insurance and IRA funding. We continue to be pleased with their customer service and their prompt attention to all our employee's needs, problems or questions."

- Robert Jenkins, Owner/Office Manager, Maverick Animal Clinic


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