There has been an increased participation in Health Spending Accounts (HSA) as 83% of employees contributed to their accounts in 2025, up from 73.4% in 2024. That’s according to The Plan Sponsor Council of America’s (PSCA) 2026 Health Savings Account Survey. Despite the growth, only one-quarter of employers position HSAs as part of a long-term retirement savings strategy.
The annual survey of plan sponsors, sponsored by HSA Bank, also underscores the role of savings and investing activity among HSA participants. Average HSA balances reached $6,477 in 2025, while 22% of participants invested their HSA savings, up from 20.3% in 2024 and 18.9% in 2023. Meanwhile, 68.5% of employers now offer HSA investment options, a 12.8% increase from 2022.
“Health Savings Accounts are evolving from a healthcare spending vehicle into an important financial wellness and long-term retirement strategy,” said Hattie Greenan, Director of Research and Communications at PSCA. “Employers are expanding support through contributions, automatic enrollment, investment options, and decision-support tools. Our findings suggest many plan sponsors have an opportunity to help employees better understand the unique role HSAs can play in preparing for healthcare expenses in retirement.”
The PSCA research found nearly two-thirds (65.5%) of employers cite employee education as the most common HSA concern while just half provide HSA education only during open enrollment. Meanwhile, only one-quarter position HSAs as part of a retirement savings strategy for employees.
Additional findings from the 2026 Health Savings Account Survey include:
- Increased Participation: Eighty-three percent of employees with an HSA contributed to their account in 2025, up from 73.4% in 2024. Average participant contributions reached $2,829 in 2025.
- Account Balances: The average account balance at the end of 2025 was $6,477.
- Employer Contributions: More than three-quarters (77.2%) of employers surveyed contribute to employee HSAs. Among employers that contribute, 61.3% provide a set contribution based on coverage level, up from 54.9% in the prior year.
- Automatic Enrollment: Nearly 46% of all organizations surveyed automatically enroll employees in an HSA when they enroll in an HSA-qualified health plan, up from 43.1% in 2024 and up from 35.1% five years ago.
- HSA Rewards: Thirty-five percent of organizations reward employees for health and wellness program participation, up from 32% the year before.