4 New Ways OBBBA Will Reshape Employee Benefits

Most of the buzz around the One Big Beautiful Bill Act (OBBBA) has focused on overtime pay and tax relief. For HR teams, though, another big impact comes from how the law changes the employee benefits landscape.

Open enrollment is just around the corner, and new rules for HSAs, dependent care FSAs, and direct primary care arrangements could reshape how employees choose their benefits and how you plan for 2026 budgets.

Overlooking these employee benefits changes could lead to confusion and unexpected costs. Now’s the time to prepare so employees make informed choices and your organization avoids costly surprises.

1. Telehealth Relief for HSAs and HDHPs

OBBBA allows telehealth services to be covered by HDHPs without affecting employee eligibility to contribute to their HSAs, retroactive to January 1, 2025. Previously, employees had to meet their deductible before telehealth coverage could count toward HSA-eligible expenses, except for preventive care. Using telehealth before meeting the deductible would have disqualified the HSA, limiting access to remote care.

Brandon Long, an employee benefits attorney at McAfee & Taft, discussed how COVID influenced this change in a recent webinar. Because of the pandemic, telehealth became critical, so the government created an exception allowing first-dollar telehealth coverage, Long explained. But that exception was being sunsetted. The OBBBA now makes telehealth relief permitted coverage, meaning someone can get telehealth on a first-dollar basis without disqualifying the HSA.

HR actions:

• Update plan documents and enrollment guides to reflect coverage for telehealth services.
• Train benefits counselors for open enrollment questions about employee benefits, including telehealth eligibility.
• Communicate retroactive eligibility so employees know they can apply it to visits earlier this year.

Takeaway: Employees gain full HSA access for telehealth, strengthening employee benefits while potentially saving hundreds and improving care options.

2. Direct Primary Care Arrangement Fees and HSAs

Effective Jan. 1, 2026, fees paid to direct primary care (DPC) arrangements can be treated as HSA-eligible medical expenses. Previously, it was unclear whether fees for direct primary care arrangements qualified as HSA-eligible medical expenses, creating uncertainty for employees using these arrangements alongside their HSAs.

“Another provision of the OBBBA that is significant or relevant to HSAs are direct primary care arrangements. These are arrangements where someone contracts with a primary care physician, usually for a fixed fee, and they get access to a primary care doctor,” Long said.

“Under the OBBBA, if someone has direct primary care – not anesthesia, drugs or lab work – and there’s a fixed recurring fee that’s, I believe, less than $150 per month, then these arrangements are allowed and do not disqualify the HSA.”

HR actions:

• Update plan communications and enrollment guides to reflect that DPC fees are HSA-eligible.
• Train benefits counselors to answer employee questions about using HSAs for DPC arrangements.
• Ensure employees understand how to properly report DPC payments for HSA purposes.

Takeaway: Direct primary care fees are now HSA-eligible, enhancing employee benefits by giving employees more flexibility and predictable costs.

3. Increased Dependent Care FSA Limits

The OBBBA increases the maximum contribution limit for dependent care flexible spending accounts (FSAs). This change allows employees to set aside more pre-tax dollars to cover eligible dependent care expenses, helping families manage costs for childcare and other qualifying services.

“Historically, the maximum contribution for dependent care arrangements has been $5,000. Effective Jan. 1, 2026, it increases to $7,500 – or $3,750 for married employees filing separately,” Long said. He also issued an important compliance reminder: Cafeteria plans must still meet nondiscrimination requirements, so testing is important.

HR actions:

• Update plan documents and enrollment guides to reflect the new dependent care FSA limits within your employee benefits program.
• Train benefits counselors to explain the increased limits, eligible expenses, and nondiscrimination requirements as part of employee benefits education.
• Communicate changes during open enrollment so employees can adjust contributions and make the most of their benefits.

Takeaway: Dependent care FSA contributions can rise to $7,500, increasing pre-tax savings for families.

4. Trump Accounts – Investment Accounts for Children

Effective July 4, 2026, OBBBA introduces Trump Accounts, tax-advantaged investment accounts for children under 18. Individuals can contribute up to $5,000 per child each year, and employers may add up to $2,500 per child, with employer contributions counting toward the $5,000 total and excluded from employee taxable income.

Both individual and employer limits will be adjusted for inflation starting in 2027. These accounts grow tax-deferred, do not require the child to have earned income, and generally cannot be accessed until the child turns 18.

Long noted that these accounts are designed to help employees save for children’s future expenses in a tax-advantaged way. He added that guidance on the administration of the accounts is still pending, and some employers may consider adding them to their employee benefits offerings.

HR actions:

• Assess whether offering Trump Accounts aligns with the organization’s total rewards strategy and the needs of the employee population.
• Evaluate potential employer contributions, communication approaches, and administrative requirements if the benefit is adopted.
• Monitor forthcoming guidance to ensure compliance and operational feasibility before implementation.

Takeaway: Employees can contribute up to $5,000 per year to Trump Accounts for children under 18, including up to $2,500 in tax-free employer contributions, giving families a flexible, tax-advantaged way to save for future expenses.

Preparing for 2026 Employee Benefits Changes

Employees now have more ways to maximize their employee benefits, from telehealth and direct primary care to expanded dependent care FSAs and new Trump Accounts.

HR teams that plan ahead, clearly communicate options, and align enrollment materials with these changes can help employees make informed choices while keeping 2026 benefits administration smooth and predictable.

Staying proactive ensures these benefits enhancements translate into real value for both staff and the organization.

Looking ahead, HR and benefits teams can take steps now to prepare for the next wave of compliance changes. Join us on December 9 for “Navigating 2025-2026 Benefits Compliance,” a free webinar covering new HSA rules, price transparency mandates and executive actions, along with practical strategies to stay audit-ready and support employee well-being. Register now.