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2021 ENROLLMENT Washington County HEALTH SAVINGS ACCOUNT DEFERRAL ELECTION FORM Name: Initial Effective Date: Social Security Number: Change Effective Date: Health Savings Account Payroll Deduction
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How to fill out health savings account deferral

How to fill out health savings account deferral
01
To fill out a health savings account deferral, follow these steps:
02
Obtain the necessary forms from your employer or HSA administrator.
03
Fill in your personal information, such as name, address, and Social Security number.
04
Indicate the amount you wish to contribute to your HSA deferral for the designated period.
05
If applicable, choose the type of investment(s) for your HSA funds.
06
Sign and date the form.
07
Submit the completed form to your employer or HSA administrator according to their instructions.
Who needs health savings account deferral?
01
Health savings account deferral is typically needed by individuals who have a high-deductible health plan (HDHP) and wish to save money for medical expenses.
02
This can include individuals who anticipate upcoming medical costs, those who want to take advantage of the tax benefits associated with HSAs, or those who want to build up a healthcare nest egg for the future.
03
However, eligibility and specific needs may vary, so it is important to consult a financial advisor or HSA administrator to determine if HSA deferral is suitable for your circumstances.
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What is health savings account deferral?
A health savings account deferral is money that an eligible individual contributes to their HSA on a pre-tax basis.
Who is required to file health savings account deferral?
Individuals who have a health savings account (HSA) and made contributions to it during the tax year are required to file health savings account deferral.
How to fill out health savings account deferral?
To fill out health savings account deferral, individuals must use Form 8889 and report their HSA contributions, deductibles, and distributions.
What is the purpose of health savings account deferral?
The purpose of health savings account deferral is to allow individuals to save money for medical expenses on a tax-deferred basis.
What information must be reported on health savings account deferral?
Information such as total contributions made to the HSA, qualifying medical expenses paid from the HSA, and any distributions from the HSA must be reported on health savings account deferral.
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