
Www.DiscoveryBenefits.com 866-451-3399 ? 866-451-3245 PO Box 2926 ? Fargo, ND 58108-2926 customerservice discoverybenefits.com Health Savings Account (HSA) Distribution Request/Account Closure Form.
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How to fill out the Forms Discoverybenefits Com online
This guide aims to provide clear and step-by-step instructions for completing the Health Savings Account (HSA) Distribution Request/Account Closure Form online. Whether you are requesting a distribution, closing your account, or ensuring accurate information, this guide helps you navigate the process smoothly.
Follow the steps to complete your form effectively
- Click the ‘Get Form’ button to obtain the form. This will allow you to access the document and begin filling it out.
- If you intend to close your account, proceed to complete this section. You have two options: select 'Close HSA and issue final normal distribution for total balance' or 'Close HSA due to mistaken enrollment or ineligibility of the account (and account has a $0 balance)'. If you are only requesting a distribution, skip this step.
- In this section, provide the requested amount for distribution, select the type of distribution from the options available, and follow any further instructions regarding excess contributions or transfers. Ensure you enter your new HSA custodian’s name and address if applicable.
- Sign the form to certify that you are the proper party to receive the payment and that all information is truthful. Write your name and date to complete this step.
Complete your HSA Distribution Request online today for a seamless experience.
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How to submit a claim on WEX?
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How to submit a claim for FSA reimbursement?
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