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HSA DESIGNATION OF BENEFICIARY HSA ACCOUNT OWNER S NAME AND ADDRESS Social Security Number Date of Birth HSA TRUSTEE S OR CUSTODIAN S NAME AND ADDRESS HSA Account Identification Home Phone Trustee

How to fill out hsa designation of beneficiary

How to fill out HSA Designation of Beneficiary:

Start by obtaining the HSA Designation of Beneficiary form from your health savings account (HSA) provider.

1. This form is typically available online or through your HSA provider's customer service department.

Fill in your personal information:

1. Provide your full legal name, address, and contact information.
2. Include your HSA account number to ensure accurate identification.

Specify the primary beneficiary:

1. Designate the person or entity who will receive the funds in your HSA account after your passing.
2. Provide their full legal name, relationship to you, and contact information.

Indicate the contingent beneficiary:

1. A contingent beneficiary is the person or entity who will receive the funds if the primary beneficiary is unable or unwilling to do so.
2. Include their full legal name, relationship to you, and contact information.

Review and sign the form:

1. Read through the form carefully, ensuring all the information provided is accurate and up-to-date.
2. Date and sign the form, confirming that you understand and agree to the designated beneficiaries.

Submit the completed form to your HSA provider:

1. Depending on your provider's instructions, you may need to send the form by mail or submit it electronically.
2. Keep a copy of the form for your records.

Who needs HSA Designation of Beneficiary?

1. Individuals who hold a health savings account (HSA) should consider designating a beneficiary.
2. It is especially important for those who want to ensure a smooth transfer of their HSA funds to their chosen beneficiary after their passing.
3. By designating a beneficiary, you can provide instructions for how your HSA funds should be distributed.

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What is hsa designation of beneficiary?

The HSA designation of beneficiary is a form filled out by an HSA account holder to designate who will inherit the funds in their HSA account upon their death.

Who is required to file hsa designation of beneficiary?

Any individual with an HSA account is encouraged to fill out an HSA designation of beneficiary form, but it is not mandatory. However, it is recommended to ensure proper distribution of funds upon the account holder's death.

How to fill out hsa designation of beneficiary?

To fill out an HSA designation of beneficiary form, the account holder must provide the name, relationship, and contact information of the chosen beneficiary. The form must be signed and dated to be valid.

What is the purpose of hsa designation of beneficiary?

The purpose of the HSA designation of beneficiary is to specify who will receive the funds in the HSA account upon the account holder's death, ensuring that the funds are distributed according to their wishes.

What information must be reported on hsa designation of beneficiary?

The HSA designation of beneficiary form typically requires the account holder to provide the beneficiary's full name, relationship to the account holder, date of birth, and contact information.