Compare Health Expense Funds

Comparing health expense funds, at a glance

HRA

HSA

FSA

RRA

Who is eligible?

All employees, as designated by the employer

Anyone covered by a qualified high-deductible plan

All employees, as defined by the IRS

All employees, as designated by the employer

Who can contribute?

Employer only

Employer, employee or both

Employer, employee or both

Employer only

Does the balance carry over?

Yes – plan can define carry-over limit; HRA balance can carry over to RRA.

Yes

Yes, up to $500, or a grace period may apply (but not both).

Yes

Can rollover contributions from another account be made to this account?

No

Yes, rollover contributions from another HSA are permitted; one-time rollover from IRA also permitted.

No

Can roll over funds from an HRA

Is the fund or account portable?

No

Yes

No

No

Are there interest or investment earnings?

No

Yes

No

No

What are the tax advantages?

Employers may deduct reimbursed employee medical expenses as a business expense; reimbursements may be excluded from the employee's gross income.

Employers with a cafeteria plan enjoy FICA tax savings.

Employers with a cafeteria plan enjoy FICA tax savings.

Employers may deduct reimbursed employee medical expenses as a business expense; reimbursements may be excluded from the employee's gross income.

Are contributions taxable income to the employee?

No

In addition, contributions are not subject to FICA or FUTA taxes.

HDHP; otherwise taxable

In addition, contributions are not subject to FICA or FUTA taxes.

No

In addition, contributions are not subject to FICA or FUTA taxes.

No

In addition, contributions are not subject to FICA or FUTA taxes.

Are distributions ⁄ reimbursements taxable income to the employee?

No

No, if made for qualified medical expenses; otherwise subject to income tax and 20% penalty.

No

No

Yes

Yes

N/A

N/A

Who is eligible?

HRA

All employees, as designated by the employer

HSA

Anyone covered by a qualified high-deductible plan

FSA

All employees, as defined by the IRS

RRA

All employees, as designated by the employer

Who can contribute?

HRA

Employer only

HSA

Employer, employee or both

FSA

Employer, employee or both

RRA

Employer only

Does the balance carry over?

HRA

Yes – plan can define carry-over limit; HRA balance can carry over to RRA.

HSA

Yes

FSA

Yes, up to $500, or a grace period may apply (but not both).

RRA

Yes

Can rollover contributions from another account be made to this account?

HRA

No

HSA

Yes, rollover contributions from another HSA are permitted; one-time rollover from IRA also permitted.

FSA

No

RRA

Can roll over funds from an HRA

Is the fund or account portable?

HRA

No

HSA

Yes

FSA

No

RRA

No

Are there interest or investment earnings?

HRA

No

HSA

Yes

FSA

No

RRA

No

What are the tax advantages?

HRA

Employers may deduct reimbursed employee medical expenses as a business expense; reimbursements may be excluded from the employee's gross income.

HSA

Employers with a cafeteria plan enjoy FICA tax savings.

FSA

Employers with a cafeteria plan enjoy FICA tax savings.

RRA

Employers may deduct reimbursed employee medical expenses as a business expense; reimbursements may be excluded from the employee's gross income.

Are contributions taxable income to the employee?

HRA

No

In addition, contributions are not subject to FICA or FUTA taxes.

HSA

HDHP; otherwise taxable

In addition, contributions are not subject to FICA or FUTA taxes.

FSA

No

In addition, contributions are not subject to FICA or FUTA taxes.

RRA

No

In addition, contributions are not subject to FICA or FUTA taxes.

Are distributions ⁄ reimbursements taxable income to the employee?

HRA

No

HSA

No, if made for qualified medical expenses; otherwise subject to income tax and 20% penalty.

FSA

No

RRA

No

HRA

Yes

HSA

Yes

FSA

N/A

RRA

N/A

HSAs are currently not available to HMO members in California and Illinois.

HRAs are currently not available to HMO members in Illinois and Small Group members in Florida.

*The Aexcel network is only available in select locations. Aexcel is not available with HMO plans. Aexcel designation is only a guide to choosing a physician. Members should consult with their existing physicians and the specialists they’re selecting before making a decision. Designations have the risk of error and should not be the sole basis for selecting a doctor.

Health benefits and health insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Florida by Aetna Health Inc. and/or Aetna Life Insurance Company. In Maryland by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.

This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Investment services are independently offered by the HSA Administrator. Aetna HealthFund HRAs are subject to employer-defined use and forfeiture rules and are unfunded liabilities of your employer. Fund balances are not vested benefits. RRAs are subject to employer-defined use and forfeiture rules. Information is believed to be accurate as of the production date; however, it is subject to change. For more information, refer to www.aetna.com.

Policy forms issued in OK include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 08/07, GR-23 and/or GR-29/GR-29N.

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