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Health Savings Account With HSA Debit Card Designation of Beneficiary for Health Savings Account Health Savings Account #: XXX Account Holder Name:, (Last) (First) (MI) Mailing Address: Street: Apt.
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How to fill out hsa designation of beneficiary

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How to fill out HSA designation of beneficiary:

01
Obtain the HSA designation of beneficiary form from your HSA provider. This form may also be available on their website or through their customer service.
02
Provide your personal information: Fill in your name, address, telephone number, and email address as requested on the form. This will ensure that your HSA provider can easily identify you and contact you if needed.
03
Designate primary beneficiary: Indicate the primary beneficiary of your HSA by providing their full name, relationship to you (e.g., spouse, child, sibling), and their contact information. This individual will have the first right to inherit your HSA funds upon your death.
04
Designate contingent beneficiary: If you wish to designate a secondary beneficiary in case the primary beneficiary predeceases you, fill in their full name, relationship, and contact information as well. This contingent beneficiary will inherit the HSA funds if the primary beneficiary cannot.
05
Specify the percentage or share of funds: If you want to distribute the HSA funds unevenly among the beneficiaries, indicate the percentage or share of funds each beneficiary should receive. Ensure that the total distribution sums up to 100%.
06
Review and sign the form: Once you have completed filling out the form, carefully review all the information provided to ensure accuracy. Sign and date the form where indicated to validate your designation.

Who needs HSA designation of beneficiary?

01
Individuals with Health Savings Accounts (HSAs): If you have an HSA, it is important to designate beneficiaries to ensure that your HSA funds are distributed according to your wishes in the event of your passing.
02
Anyone who wants to control the distribution of their HSA funds: By designating beneficiaries, you have the ability to choose who will inherit your HSA funds, rather than leaving it to state laws or default rules.
03
Individuals who prioritize estate planning: If you have specific plans for the distribution of your assets, including your HSA, designating beneficiaries is an essential part of estate planning. It allows you to ensure that your loved ones receive the HSA funds according to your wishes.
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HSA designation of beneficiary is a form that allows the account holder to specify who will receive funds from their Health Savings Account in case of their death.
Any individual who has a Health Savings Account (HSA) is required to file a designation of beneficiary form.
To fill out an HSA designation of beneficiary form, you will need to provide the name, contact information, and relationship of the designated beneficiary.
The purpose of an HSA designation of beneficiary is to ensure that funds from the account are distributed according to the account holder's wishes in the event of their death.
The HSA designation of beneficiary form must include the name, contact information, and relationship of the designated beneficiary.
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