Get Hsa Discovery Document / Set Up Form - Capital Blue Cross

Completing the HSA Discovery Document / Set Up Form - Capital Blue Cross online is an essential step in facilitating Health Savings Accounts for eligible employees. This guide provides clear, step-by-step instructions to help you navigate each section of the form efficiently.

Follow the steps to successfully complete the HSA form online.

1. Click ‘Get Form’ button to obtain the form and open it in the appropriate editor.
2. Begin by entering the health plan name, which is ‘Capital Blue Cross’, followed by the health plan customer ID.
3. Provide the general employer information, including the employer name, address, city, state, ZIP code, and contact details for both business and funding representatives.
4. Indicate the number of eligible employees and the expected number of HSA accounts by filling in the respective fields.
5. Specify who will pay the account maintenance fees, selecting either the employer or the employee by checking the appropriate box.
6. Answer whether the employer will send contributions to BNY Mellon on behalf of employees by selecting ‘Yes’ or ‘No’.
7. Determine if COBRA members should be included on the HSA eligibility file and respond accordingly.
8. Choose from the listed options on how BenefitWallet will receive employee contributions, providing any additional required information for selected options.
9. Fill in the security challenge questions, ensuring to provide responses to at least five of the six questions listed.
10. Add any additional employer contacts if necessary, ensuring they are aware of the security challenge questions.
11. Complete the authorization section by entering the user name, signature, and date.
12. Once finished, review the form for accuracy, save any changes, and download, print, or share the completed form as needed.

Start completing your HSA Discovery Document / Set Up Form online today to ensure a smooth setup process.