How Can an Employee Have BOTH an FSA and an HSA?

Both the Flexible Spending Account (FSA) and Health Savings Account (HSA) are health benefit accounts that are popular because they help employers maximize tax savings and help employees pay for their qualified health care costs.  But many times, we hear the question…

“How can an employee have BOTH an FSA and an HSA?”

The Flexible Spending Account (FSA) is a health benefit that allows employees to set aside money on a pre-tax basis to pay for health care expenses that are not covered by insurance.  FSAs help employees reduce their out-of-pocket health care costs. 

The Health Savings Account (HSA) is a triple tax advantage account that allows employees in a high deductible health plan to save and pay on a pre-tax basis for qualified health care expenses.  HSAs help employees save for the future to build wealth and to diversify their retirement portfolio.  

To answer the question, how can an employee have an FSA and HSA at the same time?  Generally speaking, you cannot have a health FSA and HSA at the same time.  However, there are 2 exceptions:  an employee can have an HSA and a Limited Purpose FSA and the Dependent Care FSA. 

The Limited Purpose FSA (LPFSA) is a health benefit that allows employees enrolled in a Health Savings Account (HSA) to set aside money on a pre-tax basis to pay for strictly dental and vision expenses not covered by insurance.  LPFSAs help employees pay for their eligible dental and vision expenses, while saving their HSA funds for future health care expenses and/or invest and save for the future. 

The Dependent Care FSA or the Dependent Care Assistance Plan (DCAP) is a benefit that allows employees to set aside money on a pre-tax basis to pay for the care of a qualifying dependent.  Since these funds are transferred from the employee’s wages on a pre-tax basis, employees can increase their take-home pay.

An employer may not be able to offer their employees BOTH the HSA and health FSA, but there are other FSA options available to maximize tax savings and to help their employees pay for other common out-of-pocket expenses on a pre-tax basis to increase take-home pay.  Please Contact BASE® at 888.386.9680 or visit to see what options available. 

ICHRA vs. QSEHRA – How Do They Compare?

Both the Individual Coverage HRA (ICHRA) and Qualified Small Employer HRA (QSEHRA) will help employees choose a health plan that is right for them, rather than the burden of choosing the one-size-fits-all traditional group health plans.  Even though both HRAs will help employers offer their employees’ health benefits, there are differences between the two. 

In 2017, small businesses were optimistic when the QSEHRA came into law.  There was now an affordable health coverage option for small employee groups, with less than 50 employees and maximum contribution caps, that helped employees pay for their qualified health care coverage.  Employees had the ability to secure their own health insurance on or off the Marketplace and the QSEHRA was quickly adopted by thousands of small employers. 

In 2020, the HRA lineup expanded with the addition of the ICHRA.  The ICHRA was opened to businesses of any size with no maximum contribution caps that provided employers with a way to help employees pay for their individual health insurance premiums.  It helped streamline benefit options and cut costs without reducing value to the health benefits offered and brought more options and savings to both employers and employees. 

Check out the comparison chart below.




Business size restrictions

Less than 50 full-time employees


Allowance amount maximum

$5,450 for self-only and $11,050 for family

None, no contribution max

Group health plan requirements

Employer cannot offer group health plan

Can offer a group health plan, but employer chooses who is offered the group plan and who is offered the ICHRA

Employee eligibility

All full-time employees are eligible

Businesses separate employees out based on 11 different classes

Best suited for

Companies that:

-  want to offer the same allowance to all full-time employees, except to vary by family status

-  employees can purchase individual health coverage or be on their spouse’s group health plan

-  have fewer than 50 full-time employees

Companies that:

-  Want to vary allowance by employee classes, such as full-time or part-time, salaried or hourly, or combination

-  want to offer allowance amounts over QSEHRA caps

-  want employees to have individual health insurance coverage

Both the QSEHRA and the ICHRA are designed for employers looking for an affordable and personalized way to provide a health benefits package to their employees.  Both HRAs are a valuable benefit, with unique differences, that can help retain and recruit valuable employees. 

Contact BASE® for more information at 888.386.9680 or visit to learn more about these HRAs and a variety of other benefit options available to assist in making health care more affordable.