HSA Transfer/Rollover Guide

Transcription

1 HSA Transfer/Rollover Guide Table of Contents Rolling Over HSA Funds... 2 Form Guidance... 2 What to Expect... 2 FAQs... 2 $25 Incentive Information... 3 HealthEquity Rollover/Transfer Request Form Rules and Conditions... 5

2 Rolling Over Your Employees HSA Funds To roll your employee s HSA funds from your former HSA administrator to HealthEquity as your new administrator: 1. HealthEquity first needs to establish an account for each employee. See your HealthEquity HSA Enrollment Guide for instructions on enrolling your employees in an HSA. 2. Have employees complete the included rollover/transfer request form. 3. Fax your employees completed rollover/transfer request forms to HealthEquity at Form Guidance You can use the HealthEquity rollover/transfer request form with most HSA administrators. If your current HSA administrator won t accept the HealthEquity form, call HealthEquity Client Services at for assistance. What to Expect Once HealthEquity receives your completed rollover/transfer request forms, it will send the rollover request to your former HSA administrator. Depending on the administrator, it can take three to six weeks for funds to be transferred to HealthEquity. For a better idea of when to expect funds in your HealthEquity account, contact your current administrator to find out its typical turnaround time. Also, be sure to see the next page for information regarding current incentives to transfer an existing HSA to HealthEquity. HSA Rollover FAQs Q. When can HSA funds be rolled over to my employees accounts? A. Your employees will first need to be set up in the HealthEquity HSA system. See your HealthEquity HSA Enrollment Guide for instructions on how to enroll your employees in a HealthEquity HSA. Q. What do I need to do to roll over my employees accounts? A. For your employees to transfer existing HSA funds from another HSA administrator to HealthEquity, the employees need to complete the HealthEquity rollover/transfer request form. Q. Where do I send the rollover/transfer request forms? A. Fax the completed forms to HealthEquity at Q. How long does the rollover process take? A. Once HealthEquity receives the completed rollover/transfer request forms, it will send the request to your current HSA administrator. Depending on the administrator, it can take three to six weeks for the funds to be transferred to HealthEquity.

3 Transfer your existing HSA to HealthEquity. We invite you to receive a $25 credit for transferring your existing Health Savings Account (HSA) balance to HealthEquity Take advantage of this limited time offer to transfer your HSA to HealthEquity and receive a $25 credit to your account. The $25 credit can be used against future account fees incurred to your HSA. Plus, the credit will not count toward your contribution limit for the year, so you can continue to deposit up to the maximum amount allowed by the IRS without worrying about an excess contribution. How to Request the Transfer 1. Fill out the HealthEquity Transfer/Rollover form, included. On this form, you will indicate the current administrator from which your balance will transfer. 2. Submit the completed form to HealthEquity. They will work with your current HSA administrator to transfer your balance (less any applicable closing fees) to a new HealthEquity Health Savings Account. You will see the transferred amount in your new HealthEquity account within 3 6 weeks from the date the form is submitted. It may take two business days from the time the funds are posted to be available for use. If you meet the criteria outlined in the Terms and Conditions section, a $25 credit will appear on your HealthEquity account statement 90 days from the date the transfer amount was posted to your new account. Terms and Conditions: Offer valid through 12/31/2013 This offer applies only to Florida Blue members. The offer applies only to transfer/rollover balances of $500 or more. The transfer amount must be received within 90 days of your HealthEquity account being established Florida Blue has selected HealthEquity as our HSA administrator to simplify enrollment and management of this type of account. The HSA dollars held in trust by HealthEquity are FDIC-insured and earn interest unless the accountholder chooses to invest the money into a variety of investment options. HealthEquity is Florida Blue s vendor of choice; however, an employee has the option to choose another qualified administrator. Florida Blue is a trade name of Blue Cross and Blue Shield of Florida, Inc., an Independent Licensee of the Blue Cross and Blue Shield Association. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. The Bancorp Bank is the FDIC-insured and independent company that holds your HSA dollars. HE FB HSA TRANSFER /3

4 Rollover/Transfer Request Form Mail or fax completed forms to: Address: HealthEquity, A n: Client Services 15 W Scenic Pointe Dr, Ste 400, Draper, UT Fax: Use the rollover/transfer request form to: 1. Roll over funds into your HealthEquity HSA that have already been distributed to you from another custodian, or, 2. Transfer monies directly from another custodian into your HealthEquity HSA. Part I Primary Account Holder Informa on Last Name First Name M.I. Street Address City State ZIP Address Health Insurance Company Day me Phone ( ) Employer Name SSN or HealthEquity ID Number (6 or 7 digits) REQUIRED Part II Transfer Informa on (Do not complete for Rollover) This request is for a custodian-to-custodian transfer or an employer-to custodian transfer. The monies currently held by another custodian are to be directly transferred to an HSA at HealthEquity. Current Custodian/Financial Ins tu on Day me Phone ( ) Address City State ZIP Current HSA/IRA/MSA Account Number Please indicate the account type that the monies will be coming from. (See rules and conditions for account type on page 2.) IRA 1 (individual retirement account) MSA 3 (medical savings account) Another HSA 3 (health savings account) Current Custodian Instruc ons: Make a check payable to HealthEquity and mail it to: HealthEquity, A n: Client Services 15 West Scenic Pointe Drive, Suite 400 Draper, UT This transfer request will close my exis ng account. I authorize the transfer of assets in the manner described above and cer fy that all of the informa on provided by me is true and complete. Account Holder Signature (required) Date Transfers 1 IRA Beginning in 2007, individuals can make one lifetime transfer from their IRA to an HSA, subject to the contribution limits applicable for the year of the transfer. Additional information can be found at 3 HSA/MSA If you instruct the custodian of your HSA or MSA to transfer funds directly to the custodian of another HSA, the transfer is not considered a rollover. There is no limit on the number of these transfers. You do not need to include the amount transferred in income, deduct it as a contribution, or include it as a distribution on IRS Form 8889, line 12a. 1 Rollover_Transfer_Form_

5 Part III Rollover Amount $ (Do not complete for Transfer) Op on 1 Check I have included a check for the amount of the distribu on from another HSA. Op on 2 Use the veri ed electronic funds transfer (EFT) account on le and associated to my HealthEquity HSA. Op on 3 Transfer the funds from the following account. (Note: address is required for EFT.) Account type: Checking Savings Financial ins tu on: City/state: Rou ng number: Account number: Form must be accompanied by a copy of a voided or actual check. Rollovers A rollover is a way to move money or property from a medical savings account (MSA) or exis ng health savings account (HSA) to a HealthEquity HSA. The Internal Revenue Code (IRC) limits how many rollovers may be taken, how quickly rollovers must be completed, and how the custodian must report the transac on. 1. Timelines The funds you receive from an MSA or HSA must be deposited into an HSA within 60 days of receiving them. When coun ng the 60 days, include weekends and holidays. Receipt generally means the day you actually have the funds in hand. For example, the 60 days would begin on the day you pick up the check from the Custodian or you receive the check in the mail. The 60 day rule is set by the IRS and cannot be changed by HealthEquity. 2. Twelve-Month Restric on You are en tled to one distribu on per year per HSA, which may be rolled over to another HSA. Twelve (12) months must pass a er receipt of one rollover before you may make another distribu on from the same HSA to rollover. Move It. Double It. Get double interest on your HealthEquity HSA. Just transfer or roll over $250 or more from another HSA to HealthEquity and get up to $25 total. Get full details at Rollover-Transfer_Form_

6 Welcome to Easy, Hassle-Free HSAs HealthEquity and offers you and your employees HSA. HealthEquity is the nation s oldest and largest dedicated health savings trustee. With HealthEquity, you can expect: Live member service any day, anytime. Dedicated employer team that contacts each employer. Dedicated employer portal Florida Blue has selected HealthEquity as our HSA administrator to simplify enrollment and management of this type of account. The HSA dollars held in trust by HealthEquity are FDIC-insured and earn interest unless the accountholder chooses to invest the money into a variety of investment options. HealthEquity is Florida Blue s vendor of choice; however, an employee has the option to choose another qualified administrator. Florida Blue is a trade name of Blue Cross and Blue Shield of Florida, Inc., an Independent Licensee of the Blue Cross and Blue Shield Association. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Copyright 2012 HealthEquity, Inc. All rights reserved. HealthEquity, the HealthEquity logo, and Building Health Savings are service marks of HealthEquity, Inc. HE FB HSARolloverGde /3