JOHN J 123 MAIN STREET RENO NV 89509 December 3, 2018 Account Number: 95000000000770 E Dear JOHN : PL Welcome to your BenefitWallet Health Savings Account (HSA), a valuable tool to pay for your current and future health care expenses on a tax-free basis. BenefitWallet is ready to help put your money to work, whether you choose to save, spend or invest with your HSA. M Your BenefitWallet HSA has already been opened with the Bank of New York Mellon, BenefitWallet s HSA custodian. To receive the greatest benefit from your HSA, we encourage you to create a User ID and Password for BenefitWallet s member portal, where you can easily and securely manage your account: Create Your User ID and Password Access the BenefitWallet member portal at www.mybenefitwallet.com Click First Time User in the upper right-hand corner of the page Enter the requested information to verify your account including your Social Security number, date of birth, and zip code If prompted, follow the steps to provide the last four digits of your BenefitWallet HSA debit card, or request and enter a Security Code Create your personal User ID and Password Provide your email address and mobile phone number, and set up your security questions to enable future account recovery and/or password resets SA te: If you have more than one BenefitWallet account, you can access them with the same User ID and Password. We re Here to Help You can access information about your HSA, including balance and last transactions, through our automated response system. You can also speak with a customer service representative: 866.274.2194 (BenefitWallet Service Center and IVR) Monday through Friday, 8 a.m. to 11 p.m. (Eastern) Saturday and Sunday, 9 a.m. to 6 p.m. (Eastern)
Frequently Asked Questions Q. What if I want to cancel my BenefitWallet HSA? A. While your BenefitWallet HSA is set to be opened automatically, you can request to have your account canceled by calling the BenefitWallet Service Center. All contributions that have posted to your account will be returned to you as a distribution. Please note that unless you transfer or roll over the distributed amount to another HSA, these funds are subject to income tax and may also be subject to a penalty tax. Q. Why should I manage my HSA online? A. The easiest and most secure way to manage your HSA is by accessing it through the BenefitWallet member portal. From there you can update your address, check account balance, recent transactions and tax information. There are also several HSA transactions you can perform including making payments. You can also access your complete transaction history, reflecting current and year-to-date debits/withdrawals, as well as all credits (deposits or interest earnings). Q. Are there HSA educational materials on the BenefitWallet member portal? A. Yes. In addition to the transactional capabilities of the BenefitWallet member portal, there is an entire Resource Center dedicated to HSA education. For access, simply click Resource Center in the top navigation bar after you log in to the member portal. Once there, you ll find educational flyers, videos, FAQs, calculators, forms and more. There are also materials available in Spanish. Q. Will I receive a BenefitWallet debit card? A. You will receive a personalized, chip-enabled debit card shortly. Activate your debit card upon receipt by following the instructions provided on the sticker on the front of the card. Your debit card can be used at an automated teller machine (ATM), provided you create a PIN. Q. Can I order a BenefitWallet debit card for my dependents? A. Yes. You may obtain additional debit cards through the member portal or by contacting the BenefitWallet Service Center. Q. Can I request a checkbook for my HSA? A. Yes. If you would like to receive a checkbook for your HSA, complete the checkbook indicator on the enclosed Master Signature Card. Q. How do I set up beneficiaries for my HSA? A. You may designate beneficiaries by logging in to the BenefitWallet member portal and clicking Beneficiaries in the secondary navigation bar. Q. Can I add funds to my HSA outside of payroll contributions? A. Yes. You may make contributions to your HSA through the member portal by clicking Make an HSA Contribution in the secondary navigation bar. You may also make a contribution by check; simply download a deposit slip from the Resource Center on the member portal and mail to the address listed. Q. Will I receive statements for my HSA? A. If you open your HSA through the BenefitWallet member portal, you will automatically receive electronic statements. If you choose to use the Master Signature Card to open your HSA, you will receive your statements in paper, and will be charged a paper statement fee. Q. Can I manage my HSA from my mobile device? A. Yes. With the BenefitWallet mobile app, you have all the same features and functionality of the member portal, plus the security of Touch ID for login. You can download the BenefitWallet app from the App Store for ios devices or Google Play for Android. App Store is a service mark of Apple Incorporated. Google Play is a trademark of Google, Inc. 2018 Conduent Inc. All rights reserved. Conduent, Conduent Agile Star and BenefitWallet are trademarks of Conduent Inc. and/or its subsidiaries in the United States and/or other countries.
Health Savings Account Fee and Rate Schedule Interest Rate and Monthly Fees INTEREST RATE Tier Interest Rate APY $0.01 - $499.99 0.050% 0.050% $500 - $2,499.99 $2,500 - $9,999.99 $10,000 - $24,999.99 $25,000 and above *Interest rates are variable and subject to change MONTHLY FEES Paper statement (per statement) $1.25 One or more of these fees may be paid for you by your employer or health plan during active employment. Requests for Debit Card, Checkbook or Copies of Documents First 2 debit cards issued at no cost. Replacement/Additional debit card... First checkbook issued at no cost. Replacement/Additional checkbooks... Copy of Check, Statement or Other Document (per item)... Other Banking Fees When Applicable 0.100% 0.150% 0.350% 0.500% 0.050% - 0.100% 0.100% - 0.150% 0.150% - 0.351% 0.351% - 0.501% Monthly Service Charge for average monthly balance of $1,000 or less $3.50 Stop Payment (per request)... Returned Item (per instance)... $5.00 $5.00 $5.00 $25.00 $25.00 Custodian Check Issuance Fee (deducted from account balance)...$25.00 Excess Contribution Reimbursement (deducted from account balance)......$25.00 Attachments / levies / legal requests / subpoenas (per request)...$75.00 ATM Usage Fee (per usage)......$2.00 Statement Reconciliation / Account Research...$20.00 per hr / $10 min charge See your Health Savings Account Deposit Agreement and Disclosures for the complete terms and conditions related to your account. te, fees disclosed will remain in effect until further notice. Interest is credited to participant accounts on the last business day of the month. For additional information regarding these fees, contact your employer, health plan or our service center. Other fees will be deducted from the balance of your Health Savings Account when incurred or as indicated. If the account balance is less than $25 at the time of the check issuance request, a fee equal to the account balance will be deducted from your account. 2018 Conduent Inc. All rights reserved. Conduent, Conduent Agile Star and BenefitWallet are trademarks of Conduent Inc. and/or its subsidiaries in the United States and/or other countries.
What does the Bank of New York Mellon do with your personal information? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect, share, and protect your personal information. Please read this notice carefully to understand what to do. The types of personal information we collect and share depend on the product or service you have with us. This information can include: Social Security Number Account balances Payment history Transaction history Checking account information When you are no longer our customer, we continue to share your information as described in this notice. All financial companies need to share customers personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customers personal information; the reasons The Bank of New York Mellon chooses to share; and whether you can limit this sharing. Reasons we can share your personal information For our everyday business purposes such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus For our marketing purposes to offer our products and services to you Does The Bank of New York Mellon share? Yes Yes Can you limit this sharing? For joint marketing with other financial companies For our affiliates everyday business purposes information about your transactions and experiences For our affiliates everyday business purposes information about your creditworthiness Yes For our affiliates to market to you For nonaffiliates to market to you
Who we are Who is providing this notice? The Bank of New York Mellon is providing this notice to customers of Health Savings Accounts. What we do How does The Bank of New York Mellon protect my personal information? How does The Bank of New York Mellon collect my personal information? Why can't I limit all sharing? Definitions Affiliates naffiliates Joint Marketing To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. We collect your personal information, for example, when you Open an account Make deposits or withdrawals from your account Use your credit or debit card Provide account information Give us your contact information We also collect your personal information from other parties, such as credit bureaus, affiliates, or other companies. Federal law gives you the right to limit only Sharing for affiliates everyday business purposes information about your creditworthiness Affiliates from using your information to market to you Sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. Companies related by common ownership or control. They can be financial and nonfinancial companies. Companies not related by common ownership or control. They can be financial and nonfinancial companies. The Bank of New York Mellon does not share information with nonaffiliates so they can market to you. A formal agreement between nonaffiliated financial companies that together market financial products or services to you. The Bank of New York Mellon doesn t jointly market. Other important information This notice applies to individual consumers who are customers or former customers. This notice replaces all previous notices of our consumer privacy policy, and may be amended at any time. We will keep you informed of changes or amendments as required by law. Questions? Call 877.472.4200
Master Signature Card Health Savings Account Complete and return this form to open your account (if you have not done so electronically), to provide a signature of record for the account, or to indicate your desire to receive a checkbook for the account. Name: JOHN J Account Number: 95000000000770 Date: By signing this card and opening a Health Savings Account with The Bank of New York Mellon (the Bank ), I agree: (a) To be bound by the Deposit Agreement & Disclosure Statement applicable to the Health Savings Account established by this card, as that agreement may be amended from time to time; (b) To be bound by the Bank s agreements and disclosures applicable to any additional accounts that I establish with the Bank in the future as an individual, custodian, or single trustee. This Master Signature Card Agreement will remain in effect as long as I continuously maintain at least one covered account with the Bank. REQUEST FOR CHECKBOOK: If you would like to receive a checkbook, please completely fill in the circle. Authorized Signature REQUIRED to process this form In accordance with the USA PATRIOT Act we are required to verify the identity of our account holders. To do so most efficiently, please provide a residential address if your welcome kit was mailed to a P.O. Box: Street Address: City: State: Zip: Returning Your Completed Master Signature Card You have two options for returning the completed Master Signature Card, either by U.S. Mail or via Courier/Overnight delivery: By U.S. Mail BenefitWallet P.O. Box 5212 Cherry Hill, NJ 08034-5212 OR By Courier/Overnight BenefitWallet 101 Woodcrest Road Cherry Hill, NJ 08003-3620 2018 Conduent Inc. All rights reserved. Conduent, Conduent Agile Star and BenefitWallet are trademarks of Conduent Inc. and/or its subsidiaries in the United States and/or other countries. *BWV2*