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    PacificSource Administrators

    Remember to Include HSA Info with Your Cafeteria Plan Documents

    PacificSource Administrators

    About the Rule 

    As you may know, a health savings account (HSA) is a type of savings account that allows reimbursement of certain medical expenses. But did you know employers who allow pretax health savings account contributions must also include HSA-specific language with their cafeteria plan documents? Don’t worry, we can help you.

    PacificSource Administrators

    How We Can Help 

    PacificSource Administrators (PSA) can provide the plan documents to allow the HSA contributions to be deducted on a pretax basis. (Note that we don’t administer HSAs). PacificSource Administrators can incorporate this information into your current flexible spending account (FSA), or premium only plan (POP) documents. If you have notified us that you allow pretax HSA contributions, the documents we've provided may already include the required language.  

    PacificSource Administrators

    HSA Language should include

    • A description specifically describing the HSA contribution benefits
    • How participants are allowed to prospectively change their salary reduction elections for HSA contributions on a monthly or more frequent basis
    • How participants who become ineligible to make HSA contributions are allowed to prospectively revoke their salary reduction elections for HSA contributions 

    PacificSource Administrators

    Reminders regarding coordination of plan benefits

    • A health savings account is compatible with a health reimbursement arrangement (HRA) that only reimburses dental and vision expenses or post-deductible expenses.
    • A post-deductible HRA will not reimburse expenses before the statutory minimum annual HDHP deductible is met. Although care must be taken if the statutory minimum and HRA threshold do not match. Employees are responsible for making sure they aren’t double dipping from the HRA credits and HSA bank.
    • A Health Savings Account (HSA) is compatible with a Health FSA component of the Flexible Spending Account (FSA) if it is limited to reimburse only dental and vision expenses. PSA refers to this account as a Limited Purpose Health FSA (LFSA).

    If you would like more information, would like custom language, or would like to amend your plan to include the HSA required language, please contact your PacificSource Administrators Client Service Representative. 


    You're always welcome to contact us!

    PacificSource Administrators
    110 International Way
    Springfield, OR 97477

    Sales and Service: PSAsales@pacificsource.com 
    Flex Benefits: PSAcustomerservice@pacificsource.com
    COBRA Benefits: COBRA@pacificsource.com

    (541) 485-7488 or toll-free (800) 422-7038  
    Fax (541) 485-8759 or toll-free (800) 575-1109