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Print Form Health Savings Account Enrollment Form Follow these easy steps: 1. Complete all entries on this Enrollment Form. Please print. 2. Sign and date this form. 3. Submit it to your Human Resources

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What is Coventry HSA?

Coventry HSA is a Health Savings Account that offers individuals a tax-advantaged way to save and pay for qualified medical expenses.

Who is required to file Coventry HSA?

Individuals who have a Coventry HSA must file if they wish to report contributions or distributions from the account.

How to fill out Coventry HSA?

To fill out Coventry HSA, individuals need to complete the necessary forms provided by Coventry or the IRS, detailing contributions, expenditures, and the account holder's information.

What is the purpose of Coventry HSA?

The purpose of Coventry HSA is to provide a means for individuals to save money for medical costs while enjoying tax benefits.

What information must be reported on Coventry HSA?

Information that must be reported includes contributions made, distributions taken, and any qualified medical expenses paid from the account.

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