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CBIZ Flex Health Savings Account Election Form Version 06.16.15Employer: Employee: SSN:Austin Area School District Address: City:StateZipCheck here to indicate an address changeDate of Hire: Email:/Date

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How to fill out hsa contribution election

01

Log in to your HSA provider's website or contact your HSA administrator directly.

02

Locate the section for contributions or elections on the website.

03

Enter the desired contribution amount for the year.

04

Confirm or save your contribution election for the year.

Who needs hsa contribution election?

01

Individuals who have a Health Savings Account (HSA) and want to make contributions to it for the year.

02

Employers who offer HSA contributions as part of their benefits package may also need to facilitate employee elections.

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What is hsa contribution election?

An HSA contribution election is a selection made by an individual regarding the amount of money they want to contribute to their Health Savings Account (HSA) for a specific tax year.

Who is required to file hsa contribution election?

Individuals who wish to make contributions to their HSA, especially those who want to specify the amount for a particular tax year, are required to file an HSA contribution election.

How to fill out hsa contribution election?

To fill out an HSA contribution election, individuals must provide their personal information, specify the amount they wish to contribute, and submit the election form to their HSA administrator or financial institution.

What is the purpose of hsa contribution election?

The purpose of the HSA contribution election is to allow individuals to define their desired contributions to their HSA, which can help save for qualified medical expenses and obtain tax benefits.

What information must be reported on hsa contribution election?

The information that must be reported includes the contributor's name, address, Social Security Number, the desired contribution amount, and the tax year for which contributions are being made.

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