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Health Savings Account (HSA) 2017 Beneits Enrollment



What is a Health Savings Account (HSA)?
An HSA is a tax-favored savings account that works in conjunction with your health HSA Eligibility

plan coverage. HSA dollars can be used to pay for qualiied medical expenses such as You may open and contribute
deductibles, copays, dental, and vision care. For a complete list of qualiied medical pre-tax to an HSA under the
following circumstances.
expenses visit irs.gov in IRS Publication 502. X Enrolled in an IRS qualified
high deductible health plan
HSA Major Benefits (HDHP)
X Funds always belong to you X Cannot be enrolled in

X Funds always roll over to use the following year a traditional PPO plan
through your spouse or
X Lowers your taxable income other employer sponsored
plan options
HSA Triple Tax Savings X Cannot be enrolled in a
X Tax deduction when you contribute to your account Government sponsored
X Tax-free earnings through investment program (Medicare,
Medicaid, Tricare, etc.)
X Tax-free withdrawal for qualiied medical expenses X Cannot have received VA
If you enroll in the $2,600 or the $3,000 deductible health plan and are eligible to benefits within the last

participate in the HSA, you must open an HSA account. Your account is required three months (unless
receiving benefits for a
to receive a GESM contribution as well as signing up your own HSA pre-tax service related disability)
deduction within our payroll system. GESM utilizes Associated Bank for its HSA X Cannot be claimed as a
accounts. dependent on someone
else’s tax return

To open an account with Associated Bank, contact the Associated Bank X Cannot have an HSA and
healthcare FSA; your
Health Savings Account Administration Department at 866.740.8666 or spouse cannot have a
associatedbank.com/hsaenroll. healthcare FSA through
his/her own employer





























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