Page 9 - Great Circle 2021 Benefits Guide
P. 9
2021
Great Circle Benefits Enrollment
Health Savings Account
If you have enrolled in Medical Plan 3 you are eligible to open a health savings account (HSA). An HSA is a
tax-favored savings account which works in conjunction with your health plan coverage. HSA dollars can be used
to pay for qualiied medical expenses such as deductibles, copays, dental, and vision care. For a complete list of
qualiied medical expenses, visit www.irs.gov in IRS Publication 502.
HSA Major Benefits HSA Triple Tax Opening Your Account
Your payroll Savings
deductions into your Tax deduction when If you are enrolling into the HSA
account belong to you you contribute to your through Central Bank for the irst time,
and go with you account visit centralparticipant.lh1ondemand.com/
Login.aspx?sec=BOB-G81471. Create an online
Funds always roll over Tax-free earnings banking proile and set up your HSA debit card PIN
from year to year through investment during this process. You will also receive a welcome
Lowers your taxable Tax-free withdrawal letter in the mail within two weeks with more
income for qualiied medical information about your account.
expenses
What You Need to Open Your Account
2021 HSA Funding Limits
Coverage Level Limit Social Security Number
Individual Coverage $3,600 Physical address and phone number
Family Coverage $7,200 Drivers’ license info (number, issue and expiration
Age 55 or Older Contribute an additional $1,000 date, state of issuance)
on top of these amounts
Conirm information from credit bureau
HSA Eligibility For questions or assistance please call the Central
You may open and contribute pre-tax to an HSA under the Bank of Boone County Relationship Banking
following circumstances. Department at 573.874.8585.
Enrolled in Medical Plan 3 If you already have an HSA through Central Bank,
Are not enrolled in a traditional PPO plan through visit www.hsacentral.net.
your spouse
Are not enrolled in a Government sponsored program
(Medicare, Medicaid, Tricare, etc.)
Have not received VA beneits within the last three
months (unless receiving beneits for a service
related disability)
Not claimed as a dependent on someone else’s
tax return
Do not have an HSA and healthcare FSA; your
spouse cannot have a healthcare FSA through his/her
own employer
9
Great Circle Benefits Enrollment
Health Savings Account
If you have enrolled in Medical Plan 3 you are eligible to open a health savings account (HSA). An HSA is a
tax-favored savings account which works in conjunction with your health plan coverage. HSA dollars can be used
to pay for qualiied medical expenses such as deductibles, copays, dental, and vision care. For a complete list of
qualiied medical expenses, visit www.irs.gov in IRS Publication 502.
HSA Major Benefits HSA Triple Tax Opening Your Account
Your payroll Savings
deductions into your Tax deduction when If you are enrolling into the HSA
account belong to you you contribute to your through Central Bank for the irst time,
and go with you account visit centralparticipant.lh1ondemand.com/
Login.aspx?sec=BOB-G81471. Create an online
Funds always roll over Tax-free earnings banking proile and set up your HSA debit card PIN
from year to year through investment during this process. You will also receive a welcome
Lowers your taxable Tax-free withdrawal letter in the mail within two weeks with more
income for qualiied medical information about your account.
expenses
What You Need to Open Your Account
2021 HSA Funding Limits
Coverage Level Limit Social Security Number
Individual Coverage $3,600 Physical address and phone number
Family Coverage $7,200 Drivers’ license info (number, issue and expiration
Age 55 or Older Contribute an additional $1,000 date, state of issuance)
on top of these amounts
Conirm information from credit bureau
HSA Eligibility For questions or assistance please call the Central
You may open and contribute pre-tax to an HSA under the Bank of Boone County Relationship Banking
following circumstances. Department at 573.874.8585.
Enrolled in Medical Plan 3 If you already have an HSA through Central Bank,
Are not enrolled in a traditional PPO plan through visit www.hsacentral.net.
your spouse
Are not enrolled in a Government sponsored program
(Medicare, Medicaid, Tricare, etc.)
Have not received VA beneits within the last three
months (unless receiving beneits for a service
related disability)
Not claimed as a dependent on someone else’s
tax return
Do not have an HSA and healthcare FSA; your
spouse cannot have a healthcare FSA through his/her
own employer
9
