Do You Realize the Power of HSAs? Probably Not!

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By Rob Grubka, Fellow in the Society of Actuaries

published 27 May 2022

Health savings accounts (HSAs) have grown in popularity since the COVID-19 pandemic caused millions of Americans to worry about getting sick. A recent industry report from Devenir reveals that the number of new HSA accounts increased by 8% last year, and this trend is only expected to continue. By the end of 2024, there will likely be more than 38 million HSAs, with assets topping $150 billion. It’s easy to understand why HSAs have increased in demand throughout the pandemic, since they are a great solution to help cover unexpected medical costs — like an unplanned hospital stay.

HSAs Make Health Care More Affordable

But HSAs are more powerful than most people realize. For example, Voya research reveals that only 2% of individuals are aware of the key attributes of HSAs.(1) With employers increasingly offering high-deductible health plans with an HSA option to their employees, chances are you already have an HSA or perhaps are considering opening one. Whether you are a pro when it comes to HSAs or just using one for the first time, we all can find value to reviewing ways that we can realize the full potential of these powerful savings, spending and investing vehicles.

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The pandemic-era trend known as the “Great Resignation” has led to a record number of people voluntarily quitting their jobs as many are changing course for a variety of reasons — increased compensation, greater flexibility or better workplace benefits, to name a few. In fact, a record 4.5 million Americans quit their jobs in March, according to the U.S. Department of Labor. Therefore, if you fall into this category and are considering switching jobs, there’s no need to worry about losing any of the hard-earned dollars you contributed to your HSA. If you leave your job (for whatever reason), your HSA comes with you — since you, not your employer, own the account.

Typically, when most people think about their workplace benefits, they may have “flashbacks” to their employer’s open enrollment period. For many, open enrollment can be a stressful time, having to consider all of your needs and making the right choices for workplace benefits for the following year. Interestingly, Voya research reveals that the majority of American workers (72%) indicated they would rather service their car, visit the dentist or prepare for tax season instead of reviewing their workplace benefit options.

Now, while you do need to enroll in an HSA during open enrollment, deciding how much to contribute from each paycheck is not something you need to stress over. What do I mean? While most employers will usually offer digital tools or calculators to help you estimate your health-related expenses for the upcoming year, at the end of the day, it’s still just an educated guess. A great feature of HSAs is that you can change how much you contribute at any time during the year. You don’t need a qualifying event — like getting married or switching jobs — to make changes, which is a typical requirement for most other workplace benefits. That’s a big relief and one less thing to worry about during open enrollment.

HSA contribution amounts are capped each year by the IRS. For 2022, the HSA contribution limits are $3,650 for individuals and $7,300 for family coverage. Individuals who are 55 or older are also eligible to make an additional $1,000 catch-up contribution. To help adjust for rising inflation, the IRS recently announced that it was boosting HSA contribution limits in 2023 — with the HSA contribution limit increasing to $3,850 for individuals and $7,750 for family coverage.

It’s not uncommon for people to confuse HSAs with their cousin, flexible spending accounts, or FSAs. While their names might sound similar, the rules that govern these accounts are quite different. One of the biggest drawbacks surrounding FSAs is the “use it or lose it” rule. In most cases, you must spend all the tax-free funds you put aside in an FSA before the end of each plan year, or risk losing the money.

The ripple effect of the pandemic shined a spotlight on a troubling reality: Most working families are not financially prepared to cover an emergency. Industry research shows that roughly 4 in 10 Americans would struggle to cover a $400 emergency expense. Faced with a short-term, unexpected need — such as a trip to the hospital — many people often dip into their retirement savings. In fact, Voya’s own customer data reveals that employees without adequate emergency savings are three times more likely to take a loan from their retirement plan.(2)

Fortunately, the dollars in your HSA can double as an emergency savings account. All HSA withdrawals used to pay for qualified medical expenses (even if unplanned) are tax free. Plus, you can choose to cover a medical bill out of pocket and then be reimbursed tax-free for that expense in the future. This strategy is another way HSAs can serve as a potential emergency savings vehicle for eligible health-related expenses. Just make sure to hold on to your receipts to verify all distributions.

Once you reach a certain threshold in your account, your HSA funds can be invested. These investment options are similar to line-ups available in typical workplace retirement accounts, like a 401(k). And you don’t need a large HSA balance to begin investing the funds. In many instances, you only need an HSA balance of $1,000 or more. However, this threshold varies by HSA plan, so check with your employer.

Unless you plan to use your HSA money for planned expenses in the near future, investing can give your money an opportunity to grow over time. For example, if you invested the 2022 HSA individual contribution limit of $3,650 in your account every year for 10 years and didn’t use any of the funds, and your account earned an overall 6% of interest each year over that time period, you would end up with about $51,000. While you would have contributed $36,500 yourself, the remaining $14,500 would come from investment earnings.

To encourage participation in high-deductible health plans with an HSA, it’s not uncommon for employers to offer incentives or matching contributions. For example, some will offer their employees $100 just for enrolling in an HSA. Plus, they may offer additional contributions throughout the year as the employee visits their doctor for an annual check-up, completes a biometrics screening or participates in other financial wellness programs, for example.

A required minimum distribution, or RMD, is an IRS-mandated amount of money that a retiree must withdraw each year from a traditional IRA or an employer-sponsored retirement account, like a 401(k). Recently, this topic has generated headlines, with lawmakers in the House overwhelming passing The Securing a Strong Retirement Act of 2022, or “SECURE 2.0.” In addition to other provisions aimed at helping American workers save for retirement, the bill proposes increasing the age to 75 when a retiree must withdraw RMDs.

While this is certainly good news, considering the current RMD age is 72 (and that was only recently increased), HSAs do not require minimum distributions — another benefit of this powerful savings vehicle. Therefore, retirees can use their HSA funds to help supplement their future retirement savings and withdraw their money when they need it. Plus, if their HSA funds are invested, it has the potential to keep growing well into their retirement years.

When you reach retirement age at 65, HSA funds can be used for non-medical expenses without being assessed a 20% penalty. Therefore, you can use your HSA to pay for general living expenses — like housing, food or travel, for example. However, the distributions will be taxed like any normal distribution from a retirement account, like an IRA or 401(k). But, if you decide to spend your HSA dollars on qualifying medical expenses, you will still enjoy tax-free distributions.

Disclaimer

This article was written by and presents the views of our contributing adviser, not the Kiplinger editorial staff. You can check adviser records with the SEC or with FINRA.

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Rob Grubka is chief executive officer of Health Solutions for Voya Financial. In this role, he is responsible for product development and management, distribution and the end-to-end customer experience for Voya’s stop loss, group life, disability and supplemental health insurance solutions, as well as health savings and spending accounts, offered to U.S. businesses and covering more than 7 million individuals through the workplace.