HSAs, HRAs, HIAs, FSAs and More

An account-based health plan (ABHP) is created when you pair a medical plan with a tax-advantaged account.*

  • Health savings account (HSA) – HSAs work with lower-premium, higher-deductible medical plans; unused funds accumulate in the HSA account year to year. Because it’s employee owned, the account stays with the employee even if they change jobs, retire or leave employment.

  • Health reimbursement arrangement (HRA) – HRAs are accounts employers can give employees. Employees use the account for reimbursements on qualified medical expenses. Unlike health savings accounts and flexible spending accounts, the employer owns and funds the HRAs.

  • Health incentive account (HIA) – HIAs are new account-based options designed for the employee to solely earn funding for healthcare expenses by participating and completing a health rewards program. They can be sponsored by Blue Shield or the employer.

  • Flexible savings account (FSA) – FSAs can be paired with any Blue Shield medical plan and offer a tax-free way for employees to save for qualified expenses during a single year. FSAs can be paired with any health plan or used alone. Funds expire if not used by the plan at year end.

  • Limited purpose flexible savings account (LPFSA) – LPFSAs are used for dental and vision expenses and can be offered alongside HSAs administered by HealthEquity.

  • Dependent care reimbursement account (DCRA) – DCRAs are non-integrated accounts that allow you to make pre-tax payroll contributions to pay for dependent care expenses.

  • Post-deductible health reimbursement arrangement (PDHRA) – PDHRAs are combined with an HSA and used to exhaust previous HRA balances.

  • Standalone health reimbursement arrangement (SAHRA) – SAHRAs are used for funding employer dollars to early retirees or retirees to pay for medical and/or Medicare premiums.

For materials and more information on ABHPs, please visit the Blue Shield/HealthEquity Sales Resource Site.


*Employees should consult with a financial adviser to determine if a tax-advantaged account such as an HSA, HRA, HIA, FSA or LPFSA is a good financial fit for them.

Blue Shield does not offer tax advice or tax-advantaged accounts such as HSAs, HRAs, HIAs, FSAs, or LPFSAs. Tax-advantaged accounts, such as HRAs, FSAs, HSAs, LPFSAs, or HIAs, are offered through HealthEquity, Blue Shield’s preferred custodial administrator, and other financial institutions. For more information about tax-advantaged accounts, eligibility and the law’s current provisions, employees should ask their financial or tax adviser. Tax-advantaged account plan features may vary by institution and may be subject to change by those institutions.

Although Blue Shield is not a financial institution and does not provide tax advice or accounts, our ABHPs give your clients the ability to pair their health coverage with an HSA, HRA, HIA, FSA, DCRA, PDHRA, SAHRA and/or LPFSA account(s) through HealthEquity.