SEARCH
   
                                                                           
LANGUAGE
Manage Your Account
Forgot username?
ACA Compliance Benefit Solutions Register For Online Access New Producer Registration
HSA for Accountholders – Open New Accounts & Manage Existing Accounts

(HSA para los Titulares de la Cuenta - Apertura y Administración de la Cuenta)

header image

General HSA Information (Información general de las HSAs)

1. HSA Product Sheet - English Download
2. HSA Product Sheet (Características de una cuenta HSA) - Spanish Download
3. HSA How To Set Up Account - English Download
4. HSA How To Set Up Account (Cómo abrir una cuenta HSA) - Spanish Download
5. Eligible Expenses - English Download
6. Eligible Expenses (Gastos elegibles) - Spanish Download
7. HSA Subscriber Website Guide Download
8. Guide to Tax Related Questions - English Download
9. Guide to Tax Related Questions (Guía para resolver sus preguntas sobre impuestos)
- Spanish
Download

HSA New Account Opening Forms (Formularios para abrir una nueva cuenta HSA)

10. HSA Individual Enrollment Kit - English Download
11. HSA Individual Enrollment Kit (Paquete de inscripción individual a una HSA) - Spanish Download
12. HSA Individual Application - English Download
13. HSA Individual Application (Solicitud de inscripción individual a una HSA) - Spanish Download
14. HSA Administrative Services Agreement - English Download
15. HSA Administrative Services Agreement (Acuerdo de servicios administrativos de una HSA)
- Spanish
Download

HSA Account Management Forms (Formularios de Administración de una cuenta HSA)

16. HSA Request For Debit Card - English Download
17. HSA Request For Debit Card (Solicitud de tarjeta de débito HSA) - Spanish Download
18. HSA Transfer Of Assets - English Download
19. HSA Beneficiary Designation Form - English Download
20. HSA Beneficiary Designation Form (Formulario de designación de beneficiarios de una HSA)
- Spanish
Download
21. HSA Deposit Form - English Download
22. HSA Deposit Form (Formulario de depósito a una HSA) - Spanish Download
23. HSA Request For Disbursement - English Download
24. HSA Request For Disbursement (Formulario para reembolso de fondos de una HSA) - Spanish Download
25. HSA Request For Account Change - English Download
26. HSA Request for Account Change (Solicitud de cambios en una cuenta HSA) - Spanish Download
27. HSA Name Sterling As Interested Party - English Download
28. HSA Transfer Of Funds Request - English Download
29. HSA Transfer Of Funds Request (Solicitud de transferencia de fondos a una HSA) - Spanish Download
30. HSA Terminate Account Form - English Download
31. HSA Terminate Account Form (Formulario para la terminación de la cuenta HSA) - Spanish Download
32. Carrier Integration Employee Collateral Download
33. HSA Request For Return Of Mistaken Contribution Download
34. Employee ACH Authorization Form Download
35. HSA Accountholder Change In Status Download
36. HSA Salary Redirection - English Download
37. HSA Salary Redirection (Redirección del salario a una HSA) - Spanish Download
38. HSA Privacy Waiver Form - English Download
39. HSA Privacy Waiver Form (Formulario de renuncia a la privacidad de una HSA) - Spanish Download
40. Carrier Integration Subscriber Guide Download

HSA for Employers - Account Opening & Management (HSA para Empleadores - Apertura y Administración de la Cuenta)

41. HSA Employer Enrollment Kit Download
42. HSA Employer "How-To" Checklist Download
43. HSA List Bill - Excel Download
44. HSA Employer Group Application Download
45. HSA Employer Website Guide Download
46. Carrier Integration Employer/Broker Collateral Download
47. HSA Employer ACH Authorization Form Download