Page 15 - Example
P. 15
Medical Beneits (continued)
Health Savings Account
The HSA enables you to set aside pre-tax funds to Fidelity HSA
pay your unreimbursed qualiied health expenses For new Fidelity registration log on to www.401k.com
you incur in the future. The HSA is a tax advantaged and register. Then click on the HSA tile to open
account in your name. Contributions can be an account.
withdrawn at your discretion to pay for eligible
healthcare expenses. For example, your HSA funds Employees who already have login credentials with
may be used to pay for out-of-pocket costs as you Fidelity can log on with their existing credentials and
work towards meeting your annual deductible, or click on the HSA tile to open an account.
use it to pay for healthcare services not covered by
the plan. If you do not incur any medical expenses, How do I access my Fidelity HSA?
you can use the HSA as a way to save for future There are multiple ways to use your HSA for payment or
healthcare needs. reimbursement of qualiied medical expenses, including:
Why Have an HSA? > Fidelity HSA debit card. The Fidelity HSA debit
An HSA simply helps you plan, save and pay for card can be used to pay for known qualiied
medical expenses at the point of sale (such as
healthcare. You own it. The money belongs to you, pharmacy prescriptions). Many providers will
even deposits made by others, such as an employer also accept your Fidelity HSA debit card for
or family member. You keep it, even if you change payment of an invoice you received in the mail.
jobs or health plans. It has triple tax beneits. For convenience, you can request debit cards
> Money deposited is federal income-tax free for your spouse and eligible dependents, too.
> Savings grow tax-free > HealthExpense. Simplify how you manage your
> Withdrawals made for qualiied expenses are HSA-eligible health plan and Fidelity Health
also income tax-free Savings Account (HSA) by handling your expenses,
payments, claims, and receipts all in one place, on
You can only contribute to the HSA bank account any device smartphone, tablet, or computer.
when you are enrolled in the HSA 1350 Health Plan. > Fidelity BillPay for Health Savings Accounts.
®
In order to assist you in paying your deductible GLG This online bill paying service enables you to
will fund the following amounts per pay period: quickly and easily make payments to healthcare
GLG HSA Contributions— providers, companies, and individuals. You can
Effective January 1, 2019 also set up an automatic payment schedule, and
keep track of all payments and activity.
Coverage Tier Per Pay Period $ > Pay out of pocket. To take advantage of the long-
Employee Only $42.18 term growth potential of your HSA, you may want to
Employee + Spouse $84.37 choose to pay for a qualiied medical expense out
Employee + Child(ren) $84.37 of pocket rather than use the funds in your HSA.
Employee + Family $84.37 > Reimburse yourself. If you do pay out of
pocket, you have the option to reimburse yourself
The maximum 2019 pre-tax contribution to an HSA from your HSA at any time without penalty.
account is $3,500 single and $7,000 family and an
additional $1,000 for members over age 55. This
includes employer and employee contributions. HSA
participants by law are not permitted to be enrolled
in any other health plan (i.e. spouse’s plan).
11
Health Savings Account
The HSA enables you to set aside pre-tax funds to Fidelity HSA
pay your unreimbursed qualiied health expenses For new Fidelity registration log on to www.401k.com
you incur in the future. The HSA is a tax advantaged and register. Then click on the HSA tile to open
account in your name. Contributions can be an account.
withdrawn at your discretion to pay for eligible
healthcare expenses. For example, your HSA funds Employees who already have login credentials with
may be used to pay for out-of-pocket costs as you Fidelity can log on with their existing credentials and
work towards meeting your annual deductible, or click on the HSA tile to open an account.
use it to pay for healthcare services not covered by
the plan. If you do not incur any medical expenses, How do I access my Fidelity HSA?
you can use the HSA as a way to save for future There are multiple ways to use your HSA for payment or
healthcare needs. reimbursement of qualiied medical expenses, including:
Why Have an HSA? > Fidelity HSA debit card. The Fidelity HSA debit
An HSA simply helps you plan, save and pay for card can be used to pay for known qualiied
medical expenses at the point of sale (such as
healthcare. You own it. The money belongs to you, pharmacy prescriptions). Many providers will
even deposits made by others, such as an employer also accept your Fidelity HSA debit card for
or family member. You keep it, even if you change payment of an invoice you received in the mail.
jobs or health plans. It has triple tax beneits. For convenience, you can request debit cards
> Money deposited is federal income-tax free for your spouse and eligible dependents, too.
> Savings grow tax-free > HealthExpense. Simplify how you manage your
> Withdrawals made for qualiied expenses are HSA-eligible health plan and Fidelity Health
also income tax-free Savings Account (HSA) by handling your expenses,
payments, claims, and receipts all in one place, on
You can only contribute to the HSA bank account any device smartphone, tablet, or computer.
when you are enrolled in the HSA 1350 Health Plan. > Fidelity BillPay for Health Savings Accounts.
®
In order to assist you in paying your deductible GLG This online bill paying service enables you to
will fund the following amounts per pay period: quickly and easily make payments to healthcare
GLG HSA Contributions— providers, companies, and individuals. You can
Effective January 1, 2019 also set up an automatic payment schedule, and
keep track of all payments and activity.
Coverage Tier Per Pay Period $ > Pay out of pocket. To take advantage of the long-
Employee Only $42.18 term growth potential of your HSA, you may want to
Employee + Spouse $84.37 choose to pay for a qualiied medical expense out
Employee + Child(ren) $84.37 of pocket rather than use the funds in your HSA.
Employee + Family $84.37 > Reimburse yourself. If you do pay out of
pocket, you have the option to reimburse yourself
The maximum 2019 pre-tax contribution to an HSA from your HSA at any time without penalty.
account is $3,500 single and $7,000 family and an
additional $1,000 for members over age 55. This
includes employer and employee contributions. HSA
participants by law are not permitted to be enrolled
in any other health plan (i.e. spouse’s plan).
11
