Form preview

Get the free Health Savings Account (HSA) Rollover/Transfer Form

Get Form
This form is used to roll over or transfer funds from another HSA or an Archer MSA into an existing Wells Fargo HSA.
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign health savings account hsa

Edit
Edit your health savings account hsa form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your health savings account hsa form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing health savings account hsa online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use the services of a skilled PDF editor, follow these steps:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit health savings account hsa. Text may be added and replaced, new objects can be included, pages can be rearranged, watermarks and page numbers can be added, and so on. When you're done editing, click Done and then go to the Documents tab to combine, divide, lock, or unlock the file.
4
Save your file. Choose it from the list of records. Then, shift the pointer to the right toolbar and select one of the several exporting methods: save it in multiple formats, download it as a PDF, email it, or save it to the cloud.
pdfFiller makes working with documents easier than you could ever imagine. Register for an account and see for yourself!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out health savings account hsa

Illustration

How to fill out Health Savings Account (HSA) Rollover/Transfer Form

01
Gather your current Health Savings Account (HSA) information.
02
Obtain the HSA Rollover/Transfer Form from your HSA custodian or financial institution.
03
Fill in your personal information, including your name, address, and Social Security number.
04
Provide details about your current HSA, such as the account number and the name of the institution holding the account.
05
Indicate the type of transfer (direct rollover or indirect rollover).
06
Sign and date the form to authorize the transfer.
07
Submit the completed form to your current HSA custodian or financial institution, and if necessary, to the new HSA provider.

Who needs Health Savings Account (HSA) Rollover/Transfer Form?

01
Individuals looking to move funds from one Health Savings Account (HSA) to another.
02
People who want to consolidate their HSAs for easier management.
03
Those who are changing HSA providers for better interest rates or lower fees.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.7
Satisfied
54 Votes

People Also Ask about

You don't have to stop HSA contributions upon reaching age 65. You won't lose HSA eligibility until you enroll in Medicare. Just keep in mind that Medicare Part A enrollment will be six months retroactive, so you'll have to account for that issue.
You must report distributions from your HSA on IRS Form 8889. You will receive a separate 1099-SA for each type of distribution made during the tax year.
The advantages of rolling over your HSA from a previous employer: Simplicity: By consolidating your HSAs into one account, you don't have to keep track of balances in multiple accounts, and you won't have multiple sets of tax documents after the rollover year.
However, a rollover may make sense for you if you have a substantial amount of money in your HSA and can reduce your maintenance fees or gain access to better investment options.
How to perform an HSA rollover Find a new HSA provider. Make sure to evaluate investment options, minimums, and any fees at new HSA providers. Request that your old HSA provider rolls over the cash to your new provider. Keep contributing to and investing through your HSA.
If you have a severe illness or medical emergency, you could drain what you added to your HSA and still pay high excess out-of-pocket costs if you haven't met your deductible.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The Health Savings Account (HSA) Rollover/Transfer Form is a document used to initiate the transfer of funds from one HSA to another, allowing individuals to manage their health savings more effectively.
Anyone who wishes to transfer funds from one HSA to another, or roll over funds into a new HSA, is required to file the Health Savings Account (HSA) Rollover/Transfer Form.
To fill out the HSA Rollover/Transfer Form, provide your personal information, details of the current and receiving HSA accounts, and specify the amount to be transferred, ensuring all required fields are completed accurately.
The purpose of the HSA Rollover/Transfer Form is to facilitate the movement of funds between HSAs without incurring taxes or penalties, allowing for better management of health savings.
The information that must be reported on the HSA Rollover/Transfer Form includes the account holder's name, contact information, account numbers, financial institutions involved, and the amount being transferred.
Fill out your health savings account hsa online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.