IRS Answers 88 Questions About HSAs

Employers can offer employee assistance programs and disease-management programs along with health savings account programs.[@@]

Shoshanna Tanner, an official at the Internal Revenue Service, and other IRS officials come to that conclusion in a guidance that answers 88 common questions about the HSA program.

The authors of the section of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 that created the HSA program wanted to give HSA holders a strong financial incentive to hold down health care costs. To give HSA holders a financial stake in thrift, the HSA section requires HSA holders to combine the accounts with high-deductible health insurance coverage.

But the requirement for a high deductible applies only to coverage for treatment of an existing illness, injury or condition. That means that HSA-compatible health insurance can offer no-deductible or low-deductible coverage for services such as well-baby visits and mammograms.

Some employers and benefits consultants had wondered about the status of EAPs, wellness programs and disease management programs.

The IRS might find that such a program provides significant medical care benefits, but, in most cases, the programs probably are HSA-compatible, Tanner writes.

One example Tanner describes is an EAP that is designed to help employees identify and resolve personal and work concerns that might affect job performance. The benefits consist primarily of free or low-cost confidential short-term counseling to identify an employee's problem and, when appropriate, referrals to an outside program to help the employee resolve the problem.

Even though the EAP provides a few counseling sessions, it is compatible with the HSA program "because it does not provide significant benefits in the nature of medical care or treatment," Tanner writes.

Another section of the guidance holds that employees can repay mistaken HSA distributions without paying penalties or taxes.

The guidance discusses many other HSA topics, such as individual eligibility rules and computation of taxes.

A copy of the guidance is on the Web at //www.irs.gov/pub/irs-drop/n-04-50.pdf