IRS Notice 2026-05 and the Impact of the OBBBA on HSAs and ICHRAs
The Treasury Department and the Internal Revenue Service recently released IRS Notice 2026-05 which outlined the provisions of the One Big Beautiful Bill Act (OBBBA) that impacted HSAs in the following respects:
- Safe Harbor for Telehealth and Remote Services. The OBBBA retroactively made permanent the safe harbor for high-deductible health plans to provide healthcare coverage using telehealth and remote services without a deductible (or with a deductible under the statutorily determined high-deductible amount) and still be considered a high-deductible health plan for purposes of HSA contributions.
- Bronze and Catastrophic Plans. Any bronze or catastrophic plan will be treated as a high-deductible health plan for HSA purposes.
- Direct Primary Care Service Arrangements. The bill sets out new rules that allow direct primary care service arrangements to be used in conjunction with an HSA.
The Notice also provided questions and answers about several topics related to the changes made to HSAs by the OBBBA such as:
- Safe Harbor for Telehealth and Remote Services. The questions focus on what services will be treated as telehealth or remote services. In addition, an answer to a question states that in-person services, medical equipment or drugs furnished in conjunction with the telehealth or remote services cannot be provided without a deductible.
- Bronze and Catastrophic Plans. The questions focus on what plans will be treated as bronze and catastrophic plans for purposes of being treated as a high-deductible health plan. Of note is the fact that the guidance said that bronze and catastrophic plans did not have to be purchased on an ACA exchange to be treated as a high-deductible health plan and confirms that ICHRAs can be used to purchase these plans.
- Direct Primary Care Service Arrangements. The questions focus on what would be treated as a direct primary care service arrangement and the treatment of HSA distributions to pay for the fees for such arrangements.
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