HSA Providers Fidelity, HealthEquity, HSA Bank, Saturna Earn High Marks From Morningstar

Health savings accounts had a good checkup in 2025, according to Morningstar Inc.’s “2025 Health Savings Account Landscape,” released in October.

Fueled by the widespread adoption of high-deductible health insurance plans, total HSA assets rose by a factor of 29 from inception in 2006 through 2024, growing to about $146 billion.

To be eligible to contribute to an HSA, an individual must be covered by an HDHP with a certain minimum deductible and maximum out-of-pocket limit.

HSAs were introduced in 2006 as features to make HDHPs “more attractive,” says Greg Carlson, a senior manager research analyst in multi-asset and alternative strategies at Morningstar. Yet while the implementation of HSAs has improved over the years in important ways, it still is not perfect.

Morningstar evaluated 11 of the largest HSA providers on two different use cases: as spending accounts used to pay for current medical costs and as long-term investing accounts. Four providers—Fidelity Investments, HealthEquity Inc., HSA Bank and Saturna Capital Corp.—earned “above average” assessments or better for both scenarios.

Best Practices

Fidelity earned the highest rating in both use cases. For the fourth consecutive year, it was the only provider to earn an overall assessment of “high” for its account spending features.

“What [Fidelity has] done well, in particular, is keep costs down,” Carlson says. “On the spending account side, they’ve offered a far better interest rate than anyone else.”

Fidelity’s interest rate—2.19% on all balances—drove most of the scoring difference. None of the other 10 providers offered a rate that exceeded 1%.

“Although some of the other 10 providers paid more than they did before interest rates rose, none paid as much as the average FDIC-insured money market fund on average account spending balances,” the report stated.

Morningstar’s research showed that maintenance fees are also important considerations for providers. Seven providers surveyed this year do not charge an ongoing maintenance fee, an increase from five in 2021. Nine of the 11 providers surveyed charged investment fees for account balances of at least $20,000 in investing and at least $2,500 in spending.

Carlson says investment fees are coming down, generally, as are maintenance fees. Fidelity and HSA Bank are the only providers that do not charge a maintenance, investment or custodial fee (at the $20,000 account balance that Morningstar evaluated), giving the firms an edge over the competition. HSA Bank, however, has waived investment fees for balances greater than $7,500.

All providers offered high-quality mutual funds or exchange-traded funds on their investment menu, Carlson notes, earning each an “above average” assessment.

Room for Improvement

The one metric for which Carlson says he hopes providers improve their offerings is menu design.

“We’d like to see a menu that offers broad diversification without overwhelming choices,” says Carlson.

According to Morningstar, research has shown that too many choices can overwhelm investors and impair their decisions. The firm recommended that HSA providers offer investment menus that are:

• Easy to navigate;
• Focused on high-quality active and passive options; and
• Do not include significant investment overlap or volatile niche funds.

Associated Banc-Corp., Lively Inc. and Saturna retained their high assessments from one year ago. Their menus offer all the core asset classes (include passive choices), limit overlap and keep a cap on niche offerings, according to Morningstar.

The One Big Beautiful Bill Act, signed by President Donald Trump on July 4, is expected to expand HSA usability. The law allows individuals enrolled in HDHPs to participate in direct primary care benefits and to pay direct primary care fees from their HSAs if their monthly fees are $150 or less ($300 or less for family coverage), effective January 1, 2026.

A representative from one HSA provider interviewed by Morningstar for the study estimated that the provisions could expand the number of potential HSA participants by 3 million to 4 million.