Partners HSA How-To’s, Forms, and Information

Employee and Employer Links

• IRS – Publication 969 – PDF Format
• IRS –  Publication 969 – Online Version

Employee

Forms

• HSA Dependent Form
• HSA Designation of Beneficiary
• HSA Contribution Form
• HSA Distribution Form
• HSA Transfer Form
• HSA Death Distribution Form

Instructions/guides/brochures

• Instructions to open your Health Savings Account for Employer
• HSA Welcome Kit
• HSA Brochure
• HSA Investment Options

Disclosures

• HSA Disclosures

Employer

Forms

• HSA Employee Contribution Worksheet
• HSA Application
• HSA Payroll Deferral Form
• HSA Employer Setup Form

Instructions/guides/brochures

• HSA Mobile App Guide
• HSA Contribution Manager Guide
• New HDHP Employer Guide
• HSA Investment Options

Disclosures

• HSA Fee Schedule