Get the free HSA Beneficiary Designation Form - HealthEquity

Beneficiary Designation Form Personal information Name: First: Last: Middle: Healthy Blue HS ASM account number: Beneficiaries Please complete all fields below for the beneficiaries you designate.

How to fill out hsa beneficiary designation form

How to fill out hsa beneficiary designation form:

1. Gather necessary information - Collect the personal details of the individual you wish to designate as your HSA beneficiary, including their full name, date of birth, and Social Security number.
2. Obtain the form - Locate the HSA beneficiary designation form, which can usually be found on your HSA provider's website or by contacting their customer service.
3. Provide your personal information - Fill in your own personal information as the account holder. This typically includes your full name, address, phone number, and Social Security number.
4. Designate your beneficiary - Indicate the full name, relationship to you, and contact information of your chosen beneficiary. Ensure that all information provided is accurate and up to date.
5. Consider contingent beneficiaries - Determine if you want to designate any contingent beneficiaries, who would inherit the HSA account if the primary beneficiary is unable to do so. If applicable, provide their information as well.
6. Review and sign - Carefully review all the information you have entered on the form to ensure its accuracy. Sign and date the form, following any additional instructions provided by your HSA provider.

Who needs hsa beneficiary designation form:

1. Individuals with Health Savings Accounts (HSAs) - Anyone who has an HSA should consider completing a beneficiary designation form. This form allows you to specify who will inherit your HSA funds in the event of your death.
2. Those who want control over their HSA assets after death - By designating a beneficiary, you ensure that your HSA funds are distributed according to your wishes, rather than being subject to probate or default rules.
3. Individuals with changing circumstances or beneficiaries - It is important to periodically review and update beneficiary designations, especially if there are significant life changes such as marriage, divorce, births, or deaths in the family.

For pdfFiller’s FAQs

What is hsa beneficiary designation form?

The HSA beneficiary designation form is a legal document that allows individuals to designate a beneficiary for their Health Savings Account (HSA). This form specifies who will inherit the funds in the HSA upon the account holder's death.

Who is required to file hsa beneficiary designation form?

Any individual who has a Health Savings Account (HSA) and wants to designate a beneficiary for their account is required to file the HSA beneficiary designation form.

How to fill out hsa beneficiary designation form?

To fill out the HSA beneficiary designation form, the account holder typically needs to provide their personal information, such as name, address, Social Security number, and date of birth. They also need to specify the beneficiary's information, including their name, relationship to the account holder, and contact details.

What is the purpose of hsa beneficiary designation form?

The purpose of the HSA beneficiary designation form is to ensure that the account holder's HSA funds are distributed according to their wishes upon their death. By designating a beneficiary, the account holder can ensure that their chosen individual inherits the HSA funds without going through probate.

What information must be reported on hsa beneficiary designation form?

The HSA beneficiary designation form typically requires the account holder to provide their personal information (name, address, Social Security number, date of birth) and the beneficiary's information (name, relationship to the account holder, contact details).

Can I create an eSignature for the hsa beneficiary designation form in Gmail?

With pdfFiller's add-on, you may upload, type, or draw a signature in Gmail. You can eSign your hsa beneficiary designation form and other papers directly in your mailbox with pdfFiller. To preserve signed papers and your personal signatures, create an account.

How can I fill out hsa beneficiary designation form on an iOS device?

Install the pdfFiller iOS app. Log in or create an account to access the solution's editing features. Open your hsa beneficiary designation form by uploading it from your device or online storage. After filling in all relevant fields and eSigning if required, you may save or distribute the document.

How do I edit hsa beneficiary designation form on an Android device?

With the pdfFiller mobile app for Android, you may make modifications to PDF files such as hsa beneficiary designation form. Documents may be edited, signed, and sent directly from your mobile device. Install the app and you'll be able to manage your documents from anywhere.