Health savings accounts (HSAs) are tax-favored IRA-type trust accounts that can be established only for eligible individuals. To be considered "eligible", the individual must be covered by a high-deductible health plan (HDHP). HSAs pay for certain qualified medical expenses of the eligible individuals, their spouses and/or tax dependents. Unlike an Archer MSA, individuals can make pre-tax HSA contributions through a Code § 125 cafeteria plan, subject to the lesser of the HDHP deductible or statutory limit (applied on a monthly basis). Alternatively, individuals with HDHP coverage can make contributions and receive an "above-the-line" tax deduction, meaning that the contributions reduce the individual's adjusted gross income before any itemized or standard deductions are considered. Investment earnings on HSA account funds generally are tax free. Ultimately, HSA funds can escape taxation entirely if they are withdrawn for qualified medical expenses. Similar to an Archer MSA, employer contributions to an HSA outside of a Code § 125 cafeteria plan are not subject to nondiscrimination rules, but must meet certain comparability requirements or will be subject to a large excise tax. Unlike an Archer MSA or HRA, both an employer and an employee may make contributions to an HSA established on the employee's behalf. An employer that contributes to an HSA and/or that offers an HSA under a Code § 125 cafeteria plan gets a tax deduction for those contributions. Employer contributions are treated as employer provided coverage for medical expenses under an accident or health plan, are excludable from an employee's gross wages, and are exempt from FICA, FUTA, and the Railroad Retirement Tax Act (RRTA), if the employer reasonably believes that the contributions will be excludable.