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FREE 6-IN-1 DISCOUNT PROGRAM

Click Here To Print Your Free 6-In-1 Discount Card

HEALTH SAVINGS ACCOUNT FORMS

• NEW ENROLLMENT
  • New Enrollment Packet – Includes Eligibility & Contribution Limits, Schedule of Fees, & Application
  • Schedule of Fees
  • HSA Application
  • HSA Rollover Packet – Complete this packet if you have an existing HSA you would like to rollover to American Health Value.
  • Employer Information Sheet – To be completed by new groups
     
• INDIVIDUAL ACCOUNT MAINTENANCE FORMS
  • Deposit Slip
  • Request Change of Address Form
  • Request Electronic Funds Transfer Form
     
• EMPLOYER ACCOUNT MAINTENANCE FORMS
  • Employer Addition/Deletion Change Sheet – For reporting changes in employee census.
  • Request Employer Distribution Sheet - For preparing group deposits
     
• TAX FORMS
  • Form 8889
  • Form 8889 Instructions
  • Review HSA Guidance and Legislation
  • Understanding Your Tax Forms (1099-SA & 5498-SA)