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HSA eligibility in three-tier health plan

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  • HSA eligibility in three-tier health plan

    I'm having a hard time getting a concrete answer to whether or not my employer-provided health insurance plan will qualify as a high deductible plan for HSA eligibility purposes. My family plan has three tiers:
    1. Services through my employer health system are free (no deductible/100% covered)
    2. Services through our insurance network have 70% coinsurance after 3k individual 9k family deductible
    3. Out of network has 5k/15k deductible, 50% coinsurance, 15k/30k maximum out of pocket

    Does anyone know how the IRS views this situation? Is it reasonable to defend by saying we get the majority of our care outside of our employer health network?

    Thank you for any insight!
    Last edited by gary649; 02-04-2021, 06:58 AM.

  • #2
    1. Only if the employer provided services are on-premise and insignificant. For example, on-premise delivery of clinic type services.

    If the services provided can be off-site and/or significant. The plan is not an HSA eligible HDHP, because 1st dollar medical care is available. Note: it does not matter if you receive the services or not, only that you can.

    Bottom Line: An HSA eligible HDHP almost always says so in its title or SPD.


    • #3
      Thank you very much for the clarification.