Get the free Health Savings Account (HSA) Designation or Change of Beneficiary Form

Este formulario está diseñado para ayudar a los propietarios de cuentas de ahorros para la salud (HSA) a seleccionar o cambiar la designación actual de beneficiarios de su HSA.

How to fill out health savings account hsa

How to fill out Health Savings Account (HSA) Designation or Change of Beneficiary Form

1. Obtain the Health Savings Account (HSA) Designation or Change of Beneficiary Form from your HSA provider.
2. Fill in your personal information, including your full name, address, and Social Security number.
3. Locate the section on the form that pertains to beneficiary designation.
4. Clearly write the names of the individuals or entities you wish to designate as your beneficiaries.
5. Specify the percentage of the HSA funds each beneficiary will receive upon your passing.
6. Review the completed form to ensure all information is accurate and legible.
7. Sign and date the form in the designated area. Some forms may require a witness signature.
8. Submit the form to your HSA provider as directed, either by mailing it in or delivering it in person.

Who needs Health Savings Account (HSA) Designation or Change of Beneficiary Form?

1. Individuals who have a Health Savings Account (HSA) and wish to designate or change their beneficiaries.
2. Anyone who wants to ensure that their HSA funds are distributed according to their wishes after their death.
3. Account holders who have had changes in personal circumstances, such as marriage, divorce, or the birth of children, that necessitate updating their beneficiaries.

People Also Ask about

What is a beneficiary designation for employee insurance?

Important Things to Remember about Designations Only the insured can sign the designation of beneficiary. Exception: If you assigned your insurance (using an RI 76-10 Assignment form), only the assignee(s) has(have) the right to make a designation. Your employing office must receive the completed form before you die.

How do I know if I am a beneficiary on an account?

To find out whether you are a beneficiary on a deceased person's bank account, you generally will need to present a certified copy of the account owner's death certificate and your government-issued ID to their bank.

What is a beneficiary designation for an HSA?

In the event of your death, your beneficiary will need to complete and return the HSA Beneficiary Account Distribution Form before the funds in your HSA can be transferred to them. They can find this form on the member website or they can call the Customer Care Center to have one sent to them.

Who do I put for beneficiary designation?

Your beneficiary can be a person, a charity, a trust, or your estate. Almost any person can be named as a beneficiary, although your state of residence or the provider of your benefits may restrict who you can name as a beneficiary. Make sure you research your state's laws before naming your beneficiary.

Who is the beneficiary of an HSA?

First, let's talk about what a beneficiary is. It's the person or legal entity who will receive your HSA funds when you pass away.

How do I change my beneficiary designation?

There would be no tax advantages in leaving the assets in the account to a trust account. The trust would incur immediate tax liability on the fair market value of the HSA for any funds left to the trust. If one has charitable organizations they want to support, they can name them as beneficiaries.

For pdfFiller’s FAQs

What is Health Savings Account (HSA) Designation or Change of Beneficiary Form?

The Health Savings Account (HSA) Designation or Change of Beneficiary Form is a legal document used to designate or update beneficiaries who will receive the funds in the HSA in the event of the account holder's death.

Who is required to file Health Savings Account (HSA) Designation or Change of Beneficiary Form?

Any individual who holds an HSA and wants to designate or change the beneficiaries of that account is required to file this form.

How to fill out Health Savings Account (HSA) Designation or Change of Beneficiary Form?

To fill out the form, the account holder must provide their personal information, list the names and contact information of the beneficiaries, specify their relationship to the account holder, and indicate the percentage of the account each beneficiary will receive.

What is the purpose of Health Savings Account (HSA) Designation or Change of Beneficiary Form?

The purpose of the form is to ensure that the account holder's wishes regarding the distribution of their HSA funds after their death are accurately documented and legally enforceable.

What information must be reported on Health Savings Account (HSA) Designation or Change of Beneficiary Form?

Information required typically includes the account holder's name, HSA account number, beneficiary names, their contact details, relationship to the account holder, and the percentage of funds each beneficiary will receive.