Yes. The recently signed OBBBA (President Trump Signs One Big Beautiful Bill Act | NFP) allows employers who sponsor qualified HDHPs to offer first-dollar telehealth services to participants without impacting HSA eligibility. This legislation makes this exception permanent, effectively retroactive as of January 1, 2025.
As background, for a participant to be eligible to make or receive tax-favored contributions to an HSA, the participant must be covered under a qualified HDHP and have no impermissible health coverage. In the context of HSA eligibility, impermissible coverage generally refers to any non-HDHP health coverage that provides “first dollar coverage,” meaning before the statutory minimum HDHP deductible is met unless an exception applies. Historically, telehealth has been considered impermissible health coverage unless the participant paid fair market value for the appointment. The CARES Act in 2020 provided temporary relief that allowed telehealth visits without cost-share. That relief was extended several times, but most recently ended as of December 31, 2024 (see our January 14, 2025, Compliance Corner article, HDHP Telehealth Relief Ends in 2025). That means that as of January 1, 2025, employers should no longer have allowed telehealth visits without cost-share or an amount below market value.
However, OBBBA now provides a permanent extension of the telehealth relief, although it remains optional for an employer. The relief is retroactive to plan years beginning on or after January 1, 2025. Employers do not have to offer telehealth without cost-sharing if they do not want to. But if telehealth is offered below market value, it would not affect HSA eligibility.
Employers wishing to take advantage of this relief should consult with their carrier or TPA regarding implementation. Non-calendar year plans that included this first dollar telehealth coverage as part of their 2024 plan year and are still in that 2024 plan year can continue it without interruption for the 2025 plan year. Calendar year plans, as well as non-calendar year plans that have already begun their 2025 plan year, and do not currently provide such coverage, may now add it. Employers should ensure their governing plan documents are updated to reflect their desired practice and that timely notice is communicated to employees, particularly if the change is made midyear. Given these administrative obligations, employers may be less likely to implement the relief for current plan years and instead choose to wait until their next renewal.
For further information regarding this telehealth relief and other employee benefit provisions of the OBBBA, please join our webinar: “The OBBBA: Benefits and Retirement Aspects of the Newly Enacted One Big Beautiful Bill Act.” Register here.