RemoveRemove IMPLEMENTATION GUIDE HEALTH SAVINGS ACCOUNT (HSA)
WELCOME Welcome to Alerus Retirement and Benefits (Alerus). We appreciate the opportunity to provide employee benefit services for you and your employees. This guide will provide you with an outline of the documentation and information necessary to implement your Health Savings Account program with Alerus. Certain portions of this guide should be completed prior to the initial submission to Alerus. We will continue to use this guide as a reference tool throughout the setup and implementation process. BEGINNING THE SETUP PROCESS In order to begin the setup process, we ask that you first review and complete Sections II through IV of this document. Once you have completed these sections, please return the updated version of this document to Alerus at hwsetup@alerus.com. The participant data referenced in Section IV should be submitted to our implementation specialist per the instructions included in that section. In addition to the census files, we will also require original copies of all HSA participant election forms be submitted to our office at: Alerus Retirement and Benefits ATTN: Stacie Ravenhorst 201 East Clark Street P.O. Box 1226 Albert Lea, MN 56007 IMPLEMENTATION TIMING If you are implementing a non-calendar year plan, Alerus will need the completed implementation paperwork returned three weeks prior to the effective date. If you are requesting a January effective date, the completed implementation paperwork will need to be submitted in early November. Please see your sales person or account executive if a more detailed time frame is needed. HSA BILLING Alerus bills for HSA services on a monthly basis. Invoices will be sent via email to the billing contact indicated in Section II on the 15 th of each month for the current month s services. Invoice detail can be accessed online at alerusrb.com. You will be assigned a user ID and password for this website during the setup process. 1
I. ALERUS SERVICE DIRECTORY CONSULTING/SETUP ASSISTANCE Please contact your broker or agent, as applicable. ROGER JORGENSEN, RHU, REBC Health and Wellness Sales Consultant HSA/FSA/HRA/COBRA/VEBA 19765 Hwy. 7, Shorewood, MN 55331 952.253.1259 :: roger.jorgensen@alerus.com RITA COOPER Health and Wellness Account Executive HSA/FSA/HRA/COBRA/VEBA 19765 Hwy. 7, Shorewood, MN 55331 952.253.1276 :: rita.cooper@alerus.com IMPLEMENTATION/SETUP STACIE RAVENHORST, CFC Implementation Specialist FSA/HRA/HSA/VEBA 201 E. Clark St., Albert Lea, MN 56007 507.379.2812 :: stacie.ravenhorst@alerus.com PLAN ADMINISTRATION SERVICES MICHELLE HINTZ, CFC Health and Welfare Services Manager 201 E. Clark St., Albert Lea, MN 56007 507.379.2801 :: michelle.hintz@alerus.com ANNE MCGINNIS HSA Supervisor 201 E. Clark St., Albert Lea, MN 56007 507.379.5776 :: anne.mcginnis@alerus.com Your plan will be assigned an administrator by the implementation specialist; you will receive this administrator s contact information once setup is complete. ALERUS CUSTOMER SERVICE Monday Friday, 7 a.m. 6 p.m. CT 877.661.4727 Toll-Free Phone 866.808.7823 Toll-Free Fax healthbenefits@alerus.com 2
II. EMPLOYER INFORMATION Employer Name Today s Date Effective Date Street Address City State ZIP Federal Tax ID State of Incorporation Type of Employer Entity (please check one) C Corporation S Corporation Partnership Sole Proprietorship Limited Liability Company Non-Profit Organization Government Church Primary Contact Title Phone Email Fax Billing Contact Title Phone Email Fax Payroll Contact Phone Email Payroll Frequency (Please Select) Date of 1 st Payroll Deductions If Bi-Weekly: 24 26 Is payroll outsourced? Yes No If yes, please identify vendor: Is COBRA outsourced? Yes No If yes, please identify vendor: Broker (Agent) Name Broker (Agent) Company Name Broker s Phone Broker s Email Additional Contact(s) for Broker Name: Phone: Email: III. PLAN INFORMATION HSA INFORMATION HSA Monthly Admin Fee Paid By # of Eligible Employees # of HSA Participants Transfer from Other Vendor Employer Employee Yes No Is the employer contributing to employees HSAs? If yes, are the contributions: Yes No Flat Dollar? Matching? Other? ER Contribution Applied: Annually Quarterly Monthly With Each Payroll Other Is there a Section 125 Cafeteria Plan document in place? If a new Section 125 Cafeteria Plan document required? Yes No Yes No Is there a limited FSA in place? Yes No Additional Comments 3
IV. PARTICIPANT CENSUS DATA The following census data is required for the setup of your participants. This data should be submitted to Alerus in an Excel spreadsheet. Each bulleted item represents a separate column required in the spreadsheet. If a specific column does not apply, (i.e., division), simply leave that column blank. HSA/FSA SPREADSHEET COLUMNS REQUIRED Employee ID # (no dashes or spaces) Last Name Middle Initial First Name Social Security # (no dashes or spaces) Address 1 Address 2 City State Zip Code Country Code (US) Email Address Home Phone Area Code Home Phone number Date of Birth (M/D/YYYY) Marital Status (S or M) Gender (M or F) Division (Optional) Payroll Deduction Frequency Payroll Effective Date (M/D/YYYY) Date of Hire (M/D/YYYY) HSA Coverage Level (S or F) Annual Employee HSA Contribution Annual Declared Amount Dependent Care FSA Debit Card (for Dep Care FSA) Y/N Annual Declared Amount Health FSA Debit Card (for Health FSA) Y/N Annual Declared Amount Limited FSA Debit Card (for Limited FSA) Y/N The following columns are only required for participants electing to use direct deposit: Bank Account Number Bank Routing (ABA) Number Checking/Savings HOW TO SUBMIT CENSUS DATA TO ALERUS The enrollment spreadsheet should be submitted to Alerus upon completion. Since this spreadsheet includes confidential information, you will need to submit via secure email connection. You will be contacted by our implementation specialist once you have completed and submitted Sections II and III. Your implementation specialist will assist you with a secure file transfer or other secure method where you will submit your enrollment spreadsheet. 4
You should use this secure file transfer to submit enrollment data, as well as other ongoing data that is confidential in nature, (i.e., information including Social Security numbers). Please contact our implementation department at hwsetup@alerus.com or 800.898.9344 with questions regarding this secure transmission. V. PLAN DOCUMENT REQUIREMENT PLAN DOCUMENT FOR HSA Since Health Savings Accounts are individually owned accounts, rather than an employersponsored plan, ERISA does not apply and no plan document is required. However, many employers will allow their employees to fund HSAs with pretax payroll deductions. This requires that a Section 125 Cafeteria plan be in place. The Section 125 plan document must incorporate the HSA by reference as a benefit funded through the plan. VI. SALIENT POINTS ABOUT HSAs* Eligibility is a key requirement to open an HSA Employee must be covered by a qualified HDHP Employee cannot be covered on a non-hdhp as a dependent Includes FSA Employee cannot be eligible for Medicare or Tricare An account must be established (paperwork plus contribution) Once established, employees can change contribution amount monthly Only claims incurred after the established date can be reimbursed Incurred claims do not have to be reimbursed out of the HSA The contributions are held in trust Healthcare Bank, a division of Bell State Bank & Trust is the custodian A beneficiary must be designated Rolls to spouse as an HSA As an asset to any other beneficiary Rolls over from year to year Accumulate at interest (capital appreciation) Contributions Can change monthly Can fund back to beginning coverage of HDHP if HSA established within the tax year. (Example coverage on HDHP 1/1. HSA opened (established) 7/1. Account can be funded back to 1/1 but only claims incurred after 7/1 are eligible. Can fund up to the annual maximum: $3,350 Single/$6,750 Family (2016); $3,400 Single/$6,750 Family (2017) 55 or older can contribute additional catch-up of $1000 Pre-tax for W2 employees (total pretax employee and employer contributions will be together in Box 12 of W2) Above the line deduction for S Corp, Partnerships, LLCs (no FICA or Medicare tax savings) Account can be pre-funded 5
Claims can be post-funded Have until April 15 of following year to contribute Testing periods apply. If someone ceases to be on a HDHP or obtains conflicting coverage tax will apply to excess contributions. Distributions No tax if for medical, dental & vision (213(d) expenses) All 213(d) expenses are eligible Non-medical distributions are taxed and a 20% excise tax applies 20% excise tax doesn t apply if account holder is 65 or older By check or direct deposit reimbursement within 5 days (Spender debit card also) End of Year Tax Info 8889 Form Must be completed by HSA participants when filing income taxes. 1099-SA Filed by Alerus and reports all HSA distributions paid for tax year. 5498-SA Filed by Alerus after 4/15 and reports final values of HSA for tax year. VII. ONGOING HSA ADMINISTRATION COMMONLY USED FORMS Employers and employees can access HSA information and forms online at alerusrb.com. TERMINATED PARTICIPANTS When an HSA participant is terminated, their account will remain open and active as long as a balance exists. The terminated employee will be removed from your company s plan and placed into an individual plan where the monthly administrative fee will be drawn directly from the balance of their HSA. They do have the option to transfer their HSA funds to another Trustee. Once we are notified of a termination, we will send the participant a letter explaining their options. We will also include the form necessary for the transfer of their HSA funds to another Trustee. It is important that you notify Alerus of terminations in a timely manner. (The HSA termination form is available on the website referenced above.) ADMINISTRATIVE INVOICES Alerus bills for HSA services on a monthly basis. Invoices will be sent via email to the billing contact indicated in Section II on the 15 th of each month for the current month s services. A one-time setup fee may apply, see the proposal for details. If applicable the fee will be included on the first invoice. Invoice detail can be accessed online at alerusrb.com. You will be assigned a user ID and password for this website during the setup process. 6
CUSTOMER SERVICE Alerus is happy to assist you and your employees with any questions, requests or concerns regarding our services. Our customer service representatives are available Monday through Friday from 7 a.m. to 6 p.m. Central time at 877.661.4727. Participants can access their accounts online at any time. Online, they will have the ability to review their balances and account history, request payment from their HSA, update personal information, modify investment elections and/or transfer funds between investments, and email Alerus customer service. Employers can also access participants account information online through our employer website. Trust services are offered through Alerus Financial, N.A., which does not provide legal or tax advice. Please consult with your legal counsel or financial advisor to determine how this information may impact your situation. This material is provided for informational and discussion purposes only. This information should not be relied upon as investment advice. Statements of fact are from sources considered reliable but no representation or warranty is made as to their completeness or accuracy. *Investment products: 1) are not FDIC insured, 2) are not deposits or other obligations of a bank or guaranteed by a bank, and 3) involve investment risk, including possible loss of principle amount invested. 7