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

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Employers are increasingly turning to the 401(k) playbook to boost their workers' uptake of health savings accounts.
HSAs are tax-advantaged accounts that carry powerful financial benefits relative to other types of savings accounts. They carry a three-pronged tax break: Money that savers contribute to HSAs doesn't count toward their taxable income; investments within the accounts grow tax-free; and accountholders can make tax-free withdrawals for qualified health expenses.
In 2025, nearly 46% of employers automatically opted workers into an HSA if the employee enrolled in a high-deductible health plan, according to a report published in August by the Plan Sponsor Council of America, a trade group representing employers.
That share has jumped from 32% in 2019, according to PSCA data.
A deductible is the amount of money consumers pay out of pocket before their insurance kicks in. High-deductible plans carry deductibles of at least $1,700 for individuals and $3,400 for families in 2026, according to the IRS.
"I think that we've seen a lot of success with automatic features in retirement plans," said Hattie Greenan, the PSCA's director of research and communications. "And employers are looking at how they can adopt that with other benefits."
Automatic enrollment — or, auto-enrollment — is generally considered a best practice among workplace retirement plans like 401(k)s when it comes to boosting participation among workers.
About 64% of employers auto-enrolled workers into a 401(k) plan in 2025, according to PSCA data. A federal retirement law known as Secure 2.0, which passed in 2022, required most newly formed 401(k) plans to auto-enroll workers starting last year.
By automatically enrolling employees into workplace savings plans, including HSAs, employers aim to remove the friction that generally comes from asking employees to opt in voluntarily — and, ideally, boost participation among workers.
"If you rely on individuals to open their own accounts, it's much more difficult" to increase participation, said Ann Brisk, senior managing director of strategy and innovation at HSA Bank, which administers health savings accounts.
Most employers make HSA contributions
Employers who auto-enroll workers into 401(k) plans automatically deduct a portion of each paycheck — 3% or 6%, for example — and add those funds into the employee's retirement account.
This setup is rare among HSA plans, experts said. Companies that auto-enroll their employees in an HSA typically seed the accounts. About 77% of employers provided employees with an HSA contribution in 2025, according to PSCA data.
In this setup, auto-enrollment is a way for employers to help their employees afford health expenses — via an employer contribution — at a time when the cost of healthcare is soaring, experts said.
"I think there's a recognition that health care is expensive, and supporting employees with that is essential," Greenan said.
About a third of employers that make a contribution — 32% — contributed between $500 and $1,000 per worker to the accounts, while 29% paid $1,350 or more and 22% paid $500 or less, the PSCA found.
Employers contribute these funds into a liquid, cash-like account within the HSA, rather than contributing to investments like a stock mutual fund, Brisk said. Employees can generally shift their HSA funds into such investments once their account balance exceeds a threshold set by their HSA provider.
In 2026, total worker and employer contributions to HSAs for self-only coverage can't exceed $4,400 for the year. The limit is $8,750 for family coverage.
401(k) 'match' also catching on in HSAs
Another common benefit within workplace retirement plans — the 401(k) match — seems to be catching on for HSAs, too, Brisk said. In this case, the employee must contribute to the HSA to receive the employer funds.
Roughly 10% of employers that pay an HSA contribution to workers match the employee's contributions, according to PSCA data. Another 7.5% are considering it, the group found.
"It's very similar to a 401(k)," Brisk said. "We think it is very easy for people to understand, and encourages people to put money in their own account."
The trend in HSA auto-enrollment also comes as more employers have turned to high-deductible health plans, which generally come with lower premiums than traditional co-pay plans, to help defray their costs.
Among employers offering health benefits to workers, 31% offered a high-deductible plan paired with an HSA in 2025, up from 4% in 2005, according to KFF, a health policy research group.

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