<Dd> HSAs are one form of tax - preferenced health care spending accounts . Others include Flexible Spending Accounts (FSAs), Archer Medical Savings Accounts (MSAs), which have been superseded by the new HSAs (although existing MSAs are grandfathered), and Health Reimbursement Accounts (HRAs). These accounts are most commonly used as part of an employee health benefit package . While there are currently no government - imposed limits to FSAs, legislation currently being reconciled between the House of Representatives and Senate would impose a cap of $2,500 . While both the House and Senate bills would adjust the cap to inflation, approximately 7 million Americans who use their FSAs to cover out - of - pocket health care expenses greater than $2,500 would be forced to pay higher taxes and health care costs . </Dd> <Dd> In July 2009, Save Flexible Spending Plans, a national grassroots advocacy organization, was formed to protect against the restricted use of FSAs in health care reform efforts, Save Flexible Spending Accounts is sponsored by the Employers Council on Flexible Compensation (ECFC), a non-profit organization "dedicated to the maintenance and expansion of the private employee benefits on a tax - advantaged basis". ECFC members include companies such as WageWorks Inc., a benefits provider based in San Mateo, California . </Dd> <Dd> Most FSA participants are middle income Americans, earning approximately $55,000 annually . Individuals and families with chronic illnesses typically receive the most benefit from FSAs; even when insured, they incur annual out - of - pocket expenses averaging $4,398 . Approximately 44 percent of Americans have one or more chronic conditions . </Dd> <Dt> Limited benefit plan </Dt>

When did us companies start offering health insurance