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Get 2013 Hsa Payroll Reduction Form - Yale University
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How to fill out the 2013 HSA Payroll Reduction Form - Yale University online
This guide provides step-by-step instructions for completing the 2013 Health Savings Account Payroll Reduction Form for Yale University online. By following these directions, users can ensure that their payroll deductions for 2013 are properly authorized and submitted.
Follow the steps to accurately complete your form online.
- Click ‘Get Form’ button to access the document and open it for editing.
- Enter your personal information in the designated fields. Provide your last name, first name, middle name, employment date, department, and phone number.
- Input your Employee Number or Social Security Number in the corresponding field.
- Authorize the salary reduction by selecting the annual amount you wish to contribute to your HSA account. You can choose an amount up to $3,250.00 for single coverage, $6,450.00 for family coverage, or a catch-up amount if eligible.
- Indicate how you would like the deductions to occur by checking one of the options for deductions: during the remainder of the year, in the first month, over the first two months, or over the first three months.
- Review the eligibility criteria outlined in the form to ensure compliance. Make sure you understand that your contributions must be used for qualified medical expenses and cannot be reimbursed through other plans.
- Sign and date the form in the designated area to complete your authorization.
- Submit your completed form by faxing it to Employee Services or by calling them if you have any questions.
Complete your documents online today to ensure your payroll deductions are set correctly.
A payroll adjustment form is used by employees to report or correct issues with their paychecks. This form helps ensure that all deductions, including those associated with the 2013 HSA Payroll Reduction Form - Yale University, are processed correctly. For accurate submissions, make sure to follow the instructions provided by the payroll department.
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