--- title: IRS Clarification on HSA Provisions in OBBBA description: IRS clarifies new HSA rules in OBBBA, including telehealth, direct primary care, and Marketplace plan eligibility changes for 2026. image: https://q4intel.com/hubfs/IRS%20Clarification%20on%20HSA%20Provisions%20in%20OBBBA%20Adobe%20Stock.jpeg --- [Skip to content](https://www.columbiabenefitsolutions.com/blog/irs-clarification-on-hsa-provisions-in-obbba-1#main-content) [![Columbia Benefit Solutions](https://www.columbiabenefitsolutions.com/hubfs/ColumbiaBenefit%20Logo_final_lg-1.png)](https://www.columbiabenefitsolutions.com/0) - [Home](https://www.columbiabenefitsolutions.com) - [Services](https://www.columbiabenefitsolutions.com/services) - [GA](https://www.columbiabenefitsolutions.com/general-agency-services) - [About](https://www.columbiabenefitsolutions.com/about) - [Blog](https://www.columbiabenefitsolutions.com/blog) - [Contact](https://www.columbiabenefitsolutions.com/contact) # IRS Clarification on HSA Provisions in OBBBA The massive budget reconciliation bill known as the One Big Beautiful Bill Act (OBBBA) was signed into law by President Trump on July 4, 2025, which included changes for health savings accounts (HSAs), dependent care assistance programs (DCAPs), student loan payments under educational assistance programs, and qualified transportation plans. The IRS recently issued [Notice 2026-5](https://www.irs.gov/pub/irs-drop/n-26-05.pdf) to clarify several HSA-related elements, particularly those involving telehealth, direct primary care arrangements, and Marketplace plan eligibility. ### Telehealth and remote care services OBBBA provided a permanent safe harbor retroactive back to the beginning of 2025, allowing coverage for telehealth and other remote services to be offered with no cost-sharing prior to meeting the minimum HDHP deductible without impacting HSA eligibility. This safe harbor reinstates and makes permanent the temporary COVID‑era flexibility that had otherwise expired for most plans.  IRS Notice 2026-5 clarifies that "telehealth" for this purpose includes:  - Services on the [Medicare telehealth list](https://www.cms.gov/medicare/coverage/telehealth/list-services) published by HHS annually; and  - Other services fitting the federal definition of “telehealth services” under SSA §1834(m), 42 CFR 410.78, and related HHS guidance.  In‑person services, equipment, or prescription drugs provided in connection with a telehealth visit may not be covered pre‑deductible without cost-sharing.  ### Direct primary care For plan years beginning in 2026, OBBBA states that certain direct primary care (DPC) arrangements may be offered with no cost-sharing without impacting HSA eligibility. DPC arrangements that meet the following requirements will not cause a loss of HSA eligibility:  - The DPC must be subject solely to a fixed monthly fee of no more than $150 for an individual or $300 for more than one individual (subject to annual indexing); and  - The DPC must involve medical care provided by a primary care practitioner. Procedures that require the use of general anesthesia, prescription drugs (other than vaccines), and laboratory services not typically administered in an ambulatory primary care setting do not qualify as primary care.  IRS Notice 20265 provides several important clarifications for DPC arrangements as described below.   #### Fixed monthly fee The fee must provide coverage for actual DPC services and not be merely an access fee; however, separate billing is permitted for non‑DPC services without affecting the arrangement’s qualification. The periodic fee can occur monthly, quarterly, semiannually or annually (up to 12 months) as long as the annualized amount does not exceed the monthly statutory limit. The HDHP cannot cover the DPC fee or count the DPC fee toward the plan's deductible or out-of-pocket maximum.  #### DPC services Only DPC arrangements that exclusively provide services defined as primary care under OBBBA allow participants to maintain HSA eligibility; an individual cannot maintain HSA eligibility for DPCs that offer a broader service arrangement by choosing not to use certain non-primary care services.  #### HSA reimbursement OBBBA also allows HSA reimbursement of DPC fees. For reimbursement purposes, the IRS clarified that a DPC arrangement may qualify for tax-favored reimbursement even if its fee exceeds the statutory monthly limit described above, but enrollment in such arrangement would make the individual ineligible to contribute to an HSA.  ### Marketplace plans Beginning in 2026, OBBBA allows bronze-level and catastrophic individual plans purchased through the Marketplace to be treated as high-deductible health plans (HDHPs) allowing for HSA eligibility, regardless of plan design. The IRS clarified that this treatment also extends to bronze plan or catastrophic plans purchased in the individual market if the same plan is available through the Marketplace. This change will have little impact on most employer plans other than those employers offering an individual coverage HRA (ICHRA) or qualified small employer HRA (QSEHRA) providing reimbursement for individual coverage.    Content originally published by Q4intelligence Photo by [Natalia Bratslavsky](https://stock.adobe.com/contributor/5505/natalia-bratslavsky?load_type=author&prev_url=detail)   [Next post](https://www.columbiabenefitsolutions.com/blog/top-7-benefits-trends-to-watch-out-for-in-2027) [All posts](https://www.columbiabenefitsolutions.com/blog) [Previous post](https://www.columbiabenefitsolutions.com/blog/the-sunk-cost-fallacy-is-quietly-shaping-your-business-heres-how-to-recognize-it-1) ## View Related Posts #### [IRS Clarification on HSA Provisions in OBBBA](https://www.columbiabenefitsolutions.com/blog/irs-clarification-on-hsa-provisions-in-obbba) #### [Saying Farewell in Style: Mastering the Art of the Offboarding Process](https://www.columbiabenefitsolutions.com/blog/saying-farewell-in-style-mastering-the-art-of-the-offboarding-process) #### [Federal Trade Commission Weighs in On Non-Competes ](https://www.columbiabenefitsolutions.com/blog/federal-trade-commission-weighs-in-on-non-competes) ![Columbia Benefit Solutions Logo](https://www.columbiabenefitsolutions.com/hubfs/ColumbiaBenefit%20Logo_final_lg-1.png) CBS guides employers and individuals in choosing the right benefit designs and insurance plans. 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Currently, we represent 15 organizations in 8 states which offer 340 plans (plan availability depends on the zip code in which you reside).  Please contact Medicare.gov, 1-800-MEDICARE or your local State Health Insurance Program (SHIP) to get information on all of your options. - Resources - [Services](https://www.columbiabenefitsolutions.com/services-archived) - [GA](https://www.columbiabenefitsolutions.com/general-agency-services-archived) - [About us](https://www.columbiabenefitsolutions.com/about-archived) - [Contact us](https://www.columbiabenefitsolutions.com/contact-archived) © 2022 All rights reserved. | [Privacy Policy](https://7961842.hs-sites.com/privacy-policy) | Powered by [Q4intelligence](https://q4intel.com) Developed by [GiantFocal](https://www.giantfocal.com) ```json { "@context" : "https://schema.org", "@id" : "https://www.columbiabenefitsolutions.com/blog/irs-clarification-on-hsa-provisions-in-obbba-1/#article", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Columbia Benefits Solutions" }, "dateModified" : "2026-01-28T21:53:57Z", "datePublished" : "2026-01-28T21:53:57Z", "description" : "IRS clarifies new HSA rules in OBBBA, including telehealth, direct primary care, and Marketplace plan eligibility changes for 2026.", "headline" : "IRS Clarification on HSA Provisions in OBBBA", "image" : { "@type" : "ImageObject", "height" : "2657", "url" : "https://q4intel.com/hubfs/IRS%20Clarification%20on%20HSA%20Provisions%20in%20OBBBA%20Adobe%20Stock.jpeg", "width" : "3986" }, "inLanguage" : "en", "isPartOf" : { "@id" : "https://www.columbiabenefitsolutions.com/blog/#blog", "@type" : "Blog", "name" : "The CBS Blog", "publisher" : { "@id" : "https://www.columbiabenefitsolutions.com/#organization" } }, "mainEntityOfPage" : { "@id" : "https://www.columbiabenefitsolutions.com/blog/irs-clarification-on-hsa-provisions-in-obbba-1/#webpage" }, "publisher" : { "@id" : "https://www.columbiabenefitsolutions.com/#organization" }, "url" : "https://www.columbiabenefitsolutions.com/blog/irs-clarification-on-hsa-provisions-in-obbba-1" } ``` ```json { "@context" : "https://schema.org", "@id" : "https://www.columbiabenefitsolutions.com/blog/irs-clarification-on-hsa-provisions-in-obbba-1/#breadcrumb", "@type" : "BreadcrumbList", "itemListElement" : [ { "@type" : "ListItem", "item" : "https://www.columbiabenefitsolutions.com", "name" : "Home", "position" : 1 } ] } ``` ```json { "@context" : "https://schema.org", "@type" : "Article", "author" : { "@type" : "Organization", "name" : "Q4intelligence, LLC" }, "datePublished" : "2025-12-18T11:00:00+00:00", "headline" : "IRS Clarification on HSA Provisions in OBBBA", "mainEntityOfPage" : { "@id" : "https://insights.q4intel.com/employers/irs-clarification-on-hsa-provisions-in-obbba", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "name" : "Q4intelligence, LLC", "url" : "https://www.q4intel.com" } } ```