With a Health Savings Account (HSA), you have the ability, within any given tax year, to contribute up to the yearly maximum contribution limits set forth by the IRS. If you or your employer are not contributing up to the annual maximum limits via your payroll, you have the option to contribute funds to your HSA on your own.
Complete the following steps to fill out a form to make an HSA contribution:
1. Download and print the HSA Individual Contribution Form.
2. Fill out all the fields on the form.
Note: Remember to include your Ameriflex HSA Account Number.
Information: If you need to look up your Ameriflex HSA Account Number, log into our Participant Portal. After logging in, click the More Details button located to the right of your Health Savings Account balance. Your account number is shown at the bottom of the box you see on the screen.
3. Attach a check or money order (payable to Ameriflex HSA) to the completed HSA Individual Contribution Form.
4. Mail the form and payment to the following address:
Ameriflex HSA
ATTN: Banking Operations
PO BOX 876274
Kansas City, MO 64187-6274
