Comparison Chart:
HSA, FSA, HRA, MSA

HSA: Health Reimbursement Account
FSA: Flexible Savings Account
HRA: Health Reimbursement Account
MSA: Medical Savings Account

	HSA	FSA	HRA	MSA
Eligibility
Small Employers	Yes	Yes	Yes	50 or fewer employees
Large Employers	Yes	Yes	Yes	No
Self Employed	Yes	No	No	Yes
Requirements
	HSA	FSA	HRA	MSA
Plan Document	No	Yes	Yes	No
High-Deductible Insurance Required	Yes	No	No	Yes
Annual IRS-DOL Form 5500	Yes, if there are employer contributions	Yes, if 100+ Participate	Yes, if 100+ Participate	No
COBRA Applies	No	Yes	Yes	No
HIPAA Certification	No	Generally No	Yes	No
Account retained by employee upon termination of employment	Yes	No	No, but terminated employees may be covered by plan	Yes
Contributions
	HSA	FSA	HRA	MSA
Employer Contributions	Optional	Optional	Required	Optional
Employee Contributions	Optional	Optional	No	Optional
Employee Tax	Contributions are tax-free	Contributions are tax-free	Claim reimbursements are tax-free	Contributions deductible on IRS Form 1040
Account prefunded by Employer	No	Yes	No	No
Permitted Uses
	HSA	FSA	HRA	MSA
Roll Unused Dollars to Next Year	Yes	No	Generally No. Employer Choice	Yes
Reimburse IRC Section 213 (d) Medical Expenses	Yes	Yes	Yes	Yes
Long-term Care Premiums Paid From Account	Yes	No	Yes	Yes
Convert to Taxable Income	Yes	No	No	Yes
	HSA	FSA	HRA	MSA