Comparative Features

FLEXIBLE SPENDING ACCOUNTS (FSA)
HEALTH REIMBURSEMENT ARRANGEMENTS (HRA))
HEALTH SAVINGS ACCOUNTS (HSA)

Account features	FSA	HRA	HSA
What is the purpose?	To reimburse qualified medical, dental, vision and/or dependent care expenses with pre-tax dollars	To reimburse qualified medical expenses	To pay for unreimbursed qualified medical expenses and save for future expenses
Who owns the account?	Employee	Employer	Employee
"Use-it-or-lose-it" by end of benefit year?	Yes - may be mitigated by Grace Period Option	Unused funds may be carried over from one benefit year to the next.	Unused funds are carried over from one benefit year to the next.
Can the employee access the account after job termination?	Yes - if COBRA eligible	Maybe —employer may opt to give access, or may keep the money.	Yes.
Can unused funds be rolled over after job termination?	No.	Yes, but only if employer allows to do so and only for medical expenses.	Yes.
Can the employee contribute to the account?	Yes.	No, only the employer may contribute.	Yes, both employee and employer can contribute in the same year.
Must this be paired with a high-deductible health plan?	No.	No.	Yes.
May this be used in conjunction with other health care spending accounts?	Yes.	Yes.	Yes.
May the money be used for expenses other than health care?	No.	No.	Yes, it then becomes taxable income and will trigger an additional 10% tax penalty.
What sections of the IRC govern?	S125,129,213(d)	S105, 213(d)	S223
What are the tax consequences?	FSA elections reduce taxable income. Saves FIT, SIT & FICA	HRA distributions are tax-free.	HSA distributions are tax-free for eligible expenses. Interest accrues tax deferred