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

by | Sep 17, 2026 | Financial

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

Employers are adopting automatic enrollment strategies for health savings accounts, drawing from proven methods used in workplace retirement plans like 401(k)s. HSAs offer significant tax advantages, including tax-free contributions, tax-free investment growth, and tax-free withdrawals for qualified health expenses.

According to a report from the Plan Sponsor Council of America published in August, nearly 46% of employers automatically enrolled workers into HSAs in 2025 when those employees selected high-deductible health plans. This represents a substantial increase from 32% in 2019. The shift reflects broader recognition that automatic enrollment removes friction from the enrollment process and increases overall participation rates among workers.

Unlike 401(k) plans, which typically involve automatic payroll deductions of 3% to 6%, HSA auto-enrollment most commonly works through employer contributions that seed employee accounts. About 77% of employers provided HSA contributions in 2025, with roughly a third contributing between $500 and $1,000 per worker annually. These funds are generally deposited into liquid, cash-like accounts that employees can later shift into investments once balances reach provider-set thresholds.

Employers are also adopting 401(k)-style matching contributions for HSAs, though this practice remains less common. Approximately 10% of employers currently offer HSA matches requiring employee contributions, with another 7.5% considering implementation. The trend reflects employer efforts to support workers facing rising healthcare expenses while high-deductible health plans have grown significantly in popularity. Among employers offering health benefits, 31% offered high-deductible plans paired with HSAs in 2025, compared to just 4% in 2005.

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