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HSA vs. FSA: Why employees confuse them

MCA-Benefits-Literacy

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By Businessolver
 on May 14, 2026
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Only 39% understand HSAs. Is low benefits literacy putting stress on paychecks?  

If employees think their funds expire every year—or worse, that they’re not eligible for any funds to begin with—they’re likely leaving hundreds of dollars on the table. All adding financial stress where there should be reliable relief.  

First off, let’s define what pre-tax savings accounts are:  

What is an HSA? An HSA, or healthcare savings account, is a pre-tax healthcare savings account. To be eligible for one, you must have a high-deductible health plan. These funds are yours for life and do not expire at the end of the plan year. They can be used for healthcare expenses, such as prescriptions and co-pays, or sit in an interest or market bearing account to grow over time.  

What is an FSA? An FSA, or a flexible spending account, is a pre-tax healthcare expense account. You do not need to have a health plan through your employer to open one up. Similar to an HSA, these funds can be used for healthcare expenses, but unlike an HSA, these funds typically expire at the end of the plan year (they do not roll over year over year). 

But defining HSAs and FSAs is only part of the equation. The real challenge for employers is making these accounts easy to understand, easy to access, and impossible to miss. 

Six reasons your consumer accounts technology should be embedded in your benefits administration tech 

Businessolver’s MyChoice® Accounts technology embeds directly into our benefits administration technology or serve as a standalone solution. However, when your consumer accounts are working hand-in-hand with your entire benefits administration strategy, our clients see results across the board: 

  1. Less confusion: Employees only need to log in once 

Employees log in once and see everything in one spot, from their health plan to their account balances, all in real-time. Our client Beacon Health took this a step further and integrated their PTO program for a true one-stop-benefits-shop. Read Beacon Health’s case study. 

  1. Integrated benefits: Financial wellness tools sit with the rest your plan options 

It’s easier to see the bigger picture when everything lives in one spot. An employee planning for an upcoming surgery can quickly check their deductible amount, their consumer account balance, and get support on plugging in any other paycheck-protective benefits (like hospital indemnity) that can help offset costs. 

  1. More time back: Reduced administrative overhead and manual workload 

Bank-like service experiences and responsive expert assistance take the burden off of you and your team. Employees can log in and get instant support with Google-like search, AI chat support, or connect with a live agent—all without having to ask HR to connect them. HR teams have confidence that their consumer accounts plans are running smoothly with the rest of their plans and file feeds. 

  1. Informed and confident consumers: Anticipating what employees need to do next 

When behavioral insights, eligibility data, and demographics live in one system, our technology can send out proactive reminders and education about next best steps. For example, an employee turns 55 and gets a reminder that they can contribute more to their HSA account. 

  1. Total transparency: Your data, in one spot, always available 

Administrative teams and leadership have instant clarity. One platform that shows accounts, activity, file and data feeds, insights, and claims—all connected. This eliminates guess work and costly errors while empowering admins with better insights to drive their strategy. 

Want to learn more? We have standalone and integration consumer spending account solutions with our MyChoice Accounts technology. Schedule a demo with us to see how we can work together.  

The data doesn’t lie: Most employees are confused about their benefits 

Pre-tax accounts like HSAs and FSAs are designed to help you stretch your healthcare dollars—but confusion keeps many employees from using them effectively. 

According to Businessolver’s 2026 Benefits Insights Report, benefits literacy remains a major challenge. In fact, 85% of employees say they’re confused about their benefits, even though 79% say they feel confident in the decisions they make during enrollment.  

This disconnect signals a real risk: Employees are making choices without fully understanding the financial tools available to them.  

That knowledge gap is especially clear when it comes to consumer spending accounts: 

  • Only 38% of employees correctly understand what an HSA is 
  • Just 47% demonstrate understanding of FSAs 
  • HSAs and accident insurance are the most frequently misunderstood benefits across all generations 

When employees miss out on pre-tax savings opportunities—or believe their funds will expire before they can use them—they may be leaving hundreds of dollars on the table. That lost savings can quickly turn into credit card debt, delayed care, or added stress at exactly the moment benefits are supposed to provide relief. 

The takeaway is clear: Low benefits literacy isn’t just a knowledge issue—it’s a financial wellbeing issue.  

Employers that proactively educate employees on how HSAs and FSAs really work and make those accounts easy to access within a connected benefits experience, are better positioned to reduce confusion, increase utilization, and help employees stretch every dollar of their paycheck further.