Social Security Number: XXXXXXXXXXXXX How much would you like to contribute to your HSA each month? $ (Not sure how much you can contribute to your HSA? Use the information below.) Signature Date 2013 Annual HSA Contributions Coverage Type Maximum Allowed Single $3,250 Family $6,450 *Catch-up contribution (age 55 +) is $1,000 Your eligibility to contribute to an HSA is determined by the effective date of your HDHP coverage.
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How to fill out the UT HealthEquity Employee HSA Contribution Form online
Completing the UT HealthEquity Employee HSA Contribution Form online is a straightforward process that allows you to manage your Health Savings Account (HSA) contributions conveniently. This guide provides step-by-step instructions to ensure you fill out the form accurately and efficiently.
Follow the steps to complete the form successfully.
- Click the ‘Get Form’ button to access the form and open it for editing.
- Begin by entering your name in the designated fields. Provide your first name, middle name, and last name as requested.
- In the section for Social Security Number, input your number in the format indicated, ensuring the required digits are filled accurately.
- Next, specify the monthly contribution amount you wish to make to your HSA. Ensure the amount entered aligns with your budget and the contribution limits provided.
- Review the maximum allowed annual contributions based on your coverage type—either Single or Family—and ensure your monthly contribution does not exceed these limits.
- If you are age 55 or older, consider whether you want to include the catch-up contribution in your monthly amount.
- Sign the form in the designated space to confirm your contributions, followed by entering today's date.
- Once you have filled out all necessary fields, you can save changes, download the form, print it, or share it as needed.
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How do I remove excess contributions from HSA HealthEquity?
Process to correct excess contributions Yes: Contributions may need to be removed by your employer by having them complete the 'HSA Employer Contribution Correction Request form. ' If they are unwilling to complete this form, please fill out the 'Distribution of Excess HSA Contribution Form.
Do employer HSA contributions need to be reported on W-2?
While employer contributions to an HSA may be excluded from the employee's income, all employer contributions, including those made by the employee through a cafeteria plan, must be reported in box 12 of the employee's W-2.
How do I add money to my HealthEquity HSA?
Go to the 'HSA' menu located under the 'My Account' tab, 'HSA' and select 'Make Contribution.' You can make a one-time contribution or set up recurring monthly contributions. If an EFT account has not been added and verified, select 'Add account.'
How do I contribute to my HealthEquity HSA?
Go to the 'HSA' menu located under the 'My Account' tab, 'HSA' and select 'Make Contribution.' You can make a one-time contribution or set up recurring monthly contributions. If an EFT account has not been added and verified, select 'Add account.'
How do I change my HSA contribution to HealthEquity?
To edit or cancel your recurring contributions: In the 'My Account' tab of the HealthEquity member portal, select 'Make Contribution' from the 'HSA' menu. From this page you can make changes to recurring contributions or cancel the contribution by clicking 'Stop/End.
How can I change my HSA contribution amount?
You can change the amount you contribute to your HSA at any time during the plan year. If you are changing the amount contributed via payroll on a pre-tax basis, check with your employer. You can also make non-payroll contributions changes using the Contribution Center in your online account.
What is the form for HSA contributions for employees?
File Form 8889 to: Report health savings account (HSA) contributions (including those made on your behalf and employer contributions). Figure your HSA deduction. Report distributions from HSAs.
What happens if I accidentally contribute too much to my HSA?
Generally, the IRS penalty equals 6 percent of your excess contributions. For example, if you have a $100 excess contribution, your fine would be $6.00. If you contributed $1,000 over, it would be $60. This penalty is called an “excise tax,” and applies to each tax year the excess contribution remains in your account.
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