HSA Forms Explained

This chart gives a short explanation of our core HSA forms and can help you decide which form will best serve your needs.
Written by Taylor Byas
Updated 2 months ago
Form Name Use form when...
HSA Account Closure Form You are looking to close your HSA
HSA Authorized Signer Form You need to add an individual who will be able to use your card and/or checks with your existing HSA
HSA Beneficiary Form You need to change a beneficiary on your existing HSA
HSA Contribution Correction Form You need to make a correction to your contribution to your HSA
HSA Distribution Reversal Form You need to make a distribution reversal to your HSA (i.e. an overpay correction, a withdrawal error, or an account closed in error)

HSA Rollover Form

You need to rollover funds from a prior third-party administrator into your existing HSA account
HSA Transfer Form You need to transfer your current HSA funds from a prior third-party administrator
HSA Individual Contribution Form You need to make a personal contribution to your HSA
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