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Aetna HealthFund Health Savings Account (HSA) Payroll Deduction Instructions This form allows you to have HSA contributions deducted from your payroll. You may use this form to authorize either a.

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You will receive a Form W-2 from your employer or your employer's payroll vendor. This form should identify any pre-tax contributions (made by you and/or your employer) to your HSA during 2022. The information will be shown in Box 12 (under a, b, c or d) and designated with code W.

Employer contributions made to your HSA are required to be treated as taxable income in California and therefore will be reported as imputed income for state tax purposes. Employee contributions made to your HSA are currently required to be treated as after-tax contributions for California state tax purposes.

This opens in a new window. One-time deposits can be made from your personal bank account into your HSA account.

Employer contributions to your Health Savings Account are reported on Form W-2 Wage and Tax Statement, Box 12 with a code "W." An amount entered here will flow to Line 7, Column C of California Schedule CA.

Contributions to an HSA are excludable from income and employment taxes if made by the employer. Earnings on amounts in HSAs are not taxable.

California and New Jersey are the only two states in the U.S. to tax these plans. When Congress established HSAs as part of the 2003 Medicare Modernization Act, the majority of states automatically conformed to the federal tax code, which defines HSAs as tax-exempt accounts.

An employee's HSA may be funded by contributions from the employer, from the employee or both. Employers may choose to contribute a set amount or make "matching" contributions. The IRS sets annual limits on the amounts that may be contributed to the HSA.

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© Copyright 1997-2025
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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