- The Sterling HSA Advantage
- Description of Services
- Services & Fees
- Documents and Forms
Documents and Forms
For the convenience of our clients—brokers and consultants, employers and individual subscribers—a number of key documents and forms can be downloaded and printed from this site.
The following files require Adobe Acrobat Reader — free software for viewing and printing PDF files.
General Information
- Sterling HSA Web Brochure (PDF, 251K)
- Frequently Asked Questions (PDF, 56K)
- HSA How to Guide (PDF, 68K)
- HSA Administrative Instructions (PDF, 40K)
- Standard Plan Fee Schedule (PDF, 24K)
- Value Plan Fee Schedule (PDF, 27K)
- eSavings Fee Schedule (PDF, 25K)
- Steps to Set Up Account (PDF, 38K)
- Sterling HSA Helpful Tips (PDF, 39K)
For Brokers & Agents
- How to Set-Up an HSA (PDF, 38K)
- Broker Checklist (PDF, 59K)
For Employers
- Administration Instructions (PDF, 41K)
- Employer Group Application (PDF, 182K)
- Employer Application Kit (PDF, 133K)
- List Bill (PDF, 78K)
- List Bill (XLS, 35K)
- Sterling Service Packages & Fees (PDF, 29K)
- Employer Checklist (PDF, 75K)
For New Subscribers to Enroll
- Individual Enrollment Application (PDF, 81K)
- Individual Enrollment Kit (PDF, 361K)
- Individual Enrollment Kit (Spanish) (PDF, 425K)
- How to Setup an Account (Spanish) (PDF, 32K)
- Service Packages and fees (Spanish) (PDF, 62K)
- Catch Up Contribution Application (PDF, 56K)
For Current Account Holders
- Request for Debit Card Form (PDF, 36K)
- Deposit Form (PDF, 27K)
- Request for Funds Disbursement Form (PDF, 37K)
- Beneficiary Designation Form (PDF, 101K)
- Account Change Form (PDF, 35K)
- Account Termination Form (PDF, 118K)
- Roll-Over Request Form (PDF, 134K)
Account Agreements
- Administrative Agreement (PDF, 37K)
- Custodial Agreement (PDF, 46K)
- Beneficiary Designation Form (PDF, 101K)
For Self Directed Investment Information
- Transfer of Assets Form (PDF, 87K)
- Sterling HSA as Interested Party (PDF, 39K)