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HSA forms

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Download and follow the instructions printed on a variety of account forms to complete common account maintenance tasks.

Sign in to your account to access forms:

  • Excess contribution refund
  • Contribution corrections
  • Redeposit funds withdrawn in error from your account
  • Rollover funds from an IRA
  • Name change 
  • Designate a beneficiary. 
    • For SSN/TIN beneficiaries, sign in
    • For Estate and Trust beneficiaries, use fax form by clicking here