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SM CIGNA Choice Fund - Health Savings Account powered by Chase Automatic Claim Forwarding Election Enrollment/Change Form Please Print Information Below EMPLOYEE INFORMATION EMPLOYEE S NAME Last First M. Please note that this IRS definition changed effective January 1 2005. use this section if this is your first Automatic Claim Forwarding election INITIAL ELECTION Select the following option and sign and date in the appropriate field below Note I.

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Under the agreement, approximately 700,000 accounts, including an estimated $1.3 billion in deposits and $175 million in investments, will migrate from JPMorgan Chase Bank to HSA Bank, a division of Webster Bank and a leading administrator and depository of health savings accounts, over a transitional period.

HSAs might not make sense if you have some type of chronic medical condition. In that case, you're probably better served by traditional health plans. HSAs might also not be a good idea if you know you will be needing expensive medical care in the near future.

HSA contributions reduce your taxable income for the year, just like tax-deferred 401(k) contributions. But if you use the money for medical expenses, you don't pay taxes on your withdrawals at all. You can also make non-medical withdrawals, but you'll pay a 20% penalty plus taxes if you do so before age 65.

The main downside of an HSA is that you must have a high-deductible health insurance plan to get one. A health insurance deductible is the amount of money you must pay out of pocket each year before your insurance plan benefits begin.

Under the agreement, approximately 700,000 accounts, including an estimated $1.3 billion in deposits and $175 million in investments, will migrate from JPMorgan Chase Bank to HSA Bank, a division of Webster Bank and a leading administrator and depository of health savings accounts, over a transitional period.

To obtain a Chase HSA Enrollment Form, contact your Anthem representative or call the Chase HSA customer service center at 1-800-778-0898, Monday - Friday, 8 a.m. to 5:30 p.m. (Eastern Time). 1. Enroll in an Anthem HSA-qualified HDHP. You must participate in a high-deductible health plan to qualify for an HSA.

HSAs can be set up with banks or credit unions. You can ask your insurance company or your employer (if you get insurance through your job) for recommended places to set up your HSA. You can also start one with the bank where you have your regular checking and savings accounts.

The Chase HSA is a special tax-advantaged account that is used with a high-deductible health plan "HDHP," and allows you and your family members to pay for various qualified medical expenses (PDF)—from co-payments at your doctor's office to pharmacy bills, dental care, vision care, and more.

You pay less out-of-pocket due to the lower deductible and copay, but pay more each month in premium. HSA plans generally have lower monthly premiums and a higher deductible. You may pay more out-of-pocket for medical expenses, but you can use your HSA to cover those costs, and you pay less each month for your premium.

Access funds at an ATM, transfer funds to your bank account through the HSA online portal, or request a check from your HSA online.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232