Page 6 - 2020-21 Sample Benefits Guide
P. 6
20XX
HSA Eligibility Health Savings
You may open and contribute pre-tax to an HSA under the Account (HSA)
following circumstances.
Enrolled in an IRS qualiied high deductible health plan A health savings account (HSA) is a tax-favored
(HDHP) personal savings account which works with your high
Not enrolled in a traditional PPO plan through your deductible health plan. HSA dollars can be used to
pay for qualiied medical expenses such as deductibles,
spouse or other employer sponsored plan options copays, dental, and vision care. For a complete list of
Not enrolled in a Government sponsored program qualiied medical expenses visit www.irs.gov in IRS
(Medicare, Medicaid, Tricare, etc.) Publication 502.
Have not received VA beneits within the last three
months (unless receiving beneits for a service related HSA Major Benefits
disability) Funds always belong to you
Not claimed as a dependent on someone else’s tax
return Funds always roll over from year to year
Do not have an HSA and healthcare FSA; your spouse Lowers your taxable income
also cannot have a healthcare FSA through his/her own Helps you build a healthcare nest egg for
employer emergencies or retirement
HSA Triple Tax Savings
Tax deduction when you contribute to your account
Tax-free earnings through investment
Tax-free withdrawal for qualiied medical expenses
[20XX] HSA Funding Limits
Coverage Level Limit
Individual Coverage $3,500
Family Coverage $7,000
Age 55 or Older Contribute an additional $1,000 on
top of these amounts
Opening an HSA
We partner with [Carrier/Bank] for our HSA program.
You may open an HSA by following the steps below.
Visit www.[Carrier].com for more information.
1. [insert details]
2. [insert details]
3. [insert details]
6
HSA Eligibility Health Savings
You may open and contribute pre-tax to an HSA under the Account (HSA)
following circumstances.
Enrolled in an IRS qualiied high deductible health plan A health savings account (HSA) is a tax-favored
(HDHP) personal savings account which works with your high
Not enrolled in a traditional PPO plan through your deductible health plan. HSA dollars can be used to
pay for qualiied medical expenses such as deductibles,
spouse or other employer sponsored plan options copays, dental, and vision care. For a complete list of
Not enrolled in a Government sponsored program qualiied medical expenses visit www.irs.gov in IRS
(Medicare, Medicaid, Tricare, etc.) Publication 502.
Have not received VA beneits within the last three
months (unless receiving beneits for a service related HSA Major Benefits
disability) Funds always belong to you
Not claimed as a dependent on someone else’s tax
return Funds always roll over from year to year
Do not have an HSA and healthcare FSA; your spouse Lowers your taxable income
also cannot have a healthcare FSA through his/her own Helps you build a healthcare nest egg for
employer emergencies or retirement
HSA Triple Tax Savings
Tax deduction when you contribute to your account
Tax-free earnings through investment
Tax-free withdrawal for qualiied medical expenses
[20XX] HSA Funding Limits
Coverage Level Limit
Individual Coverage $3,500
Family Coverage $7,000
Age 55 or Older Contribute an additional $1,000 on
top of these amounts
Opening an HSA
We partner with [Carrier/Bank] for our HSA program.
You may open an HSA by following the steps below.
Visit www.[Carrier].com for more information.
1. [insert details]
2. [insert details]
3. [insert details]
6
