With HSAs, employers turning to the 401(k) playbook

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Employers are increasingly adopting HSA strategies resembling the proven 401(k) model to drive higher worker engagement with health savings accounts.

HSA accounts provide tax‑advantaged benefits that include three key advantages: contributions are excluded from taxable income, investment earnings grow tax‑free, and qualified health expense withdrawals remain tax‑free.

In 2025, nearly half of employers automatically enrolled employees into HSAs whenever workers chose high‑deductible health plans, per an August report from the Plan Sponsor Council of America. That rate rose dramatically from 32% in 2019, according to PSCA data.

A deductible represents the amount individuals pay out of pocket before insurance coverage begins. By 2026, deductibles will reach at least $1,700 for individuals and $3,400 for families under high‑deductible plans, per the IRS.

“We’ve seen substantial success with automatic enrollment in retirement plans,” said Hattie Greenan, director of research and communications at the PSCA. “Employers are now exploring how to apply that approach to complementary benefits.”

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Auto‑enrollment—also known as auto‑enrollment—is widely regarded as a best practice within workplace retirement planning to boost participant rates.

Approximately 64% of employers auto‑enrolled staff into 401(k) plans in 2025, following the Secure 2.0 federal law enacted in 2022 that mandated auto‑enrollment for new 401(k) plans starting earlier that year.

By automatically adding employees to workplace savings vehicles, including HSAs, employers seek to eliminate the friction inherent in voluntary accounts and aim to significantly raise participation levels.

“When businesses rely on individuals to open their own HSAs, increasing involvement proves considerably harder,” noted Ann Brisk, senior managing director of strategy and innovation at HSA Bank, which administers HSA services.

Widespread HSA Contribution Practices

Organizations that automate HSA enrollment typically seed employee accounts directly. According to PSCA data, about 77% of employers provided HSA contributions to their workforces in 2025.

“This configuration enables employers to support staff health costs more effectively via employer funding during periods when healthcare expenses are rapidly rising,” Greenan explained.

Roughly a third of employers offering contributions contributed $500 to $1,000 per employee, while another 29% added $1,350 or more, and 22% contributed $500 or less, the council reported.

Contributions flow into liquid, cash‑like HSA accounts rather than direct equity investments. Once balances surpass thresholds set by providers, eligible employees may allocate funds toward low‑cost index funds or other investment options.

The aggregate amount that can be contributed by workers and employers combined toward self‑only HSA coverage cannot exceed $4,400 annually—in 2026 the cap rises to $8,750 for family coverage.

Growing Popularity of 401(k) Matches Within HSAs

An additional feature common to traditional 401(k) plans—employer matching—is gaining traction in HSA structures as well, Brisk observed. In such arrangements, employees must contribute personal funds to receive employer‑sponsored additions.

Income is matched by roughly 10% of employers providing HSA contributions according to PSCA data. Another 7.5% are evaluating this option, indicating broader interest in integrated matches.

“It mirrors typical 401(k) mechanics,” Brisk noted. “The construct is straightforward for recipients, and it encourages greater discretionary employee savings.”

The upward momentum in HSA auto‑enrollment coincides with expanding adoption of high‑deductible health plans, which generally present lower premium costs compared to conventional co‑pay arrangements, helping reduce overall benefits outlays.

Among firms offering health benefits to staff, 31% paired high‑deductible plans with HSAs in 2025—a dramatic increase from just 4% in 2005, per KFF.

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