Throughout the Plan Year:

BASIC HSA Guide for Participants
Click here to open

HSA Enrollment Form
Employees use this form to elect an HSA and the amount they would like to have payroll deducted to contribute to their HSA account.

2021: Click here to open

HSA Participant Information Change Form

Complete this online form if an employee has a status changes such as an increase in an election, change in per pay, termination of coverage, or address change.
Click here to open

2021 HSA Employer Renewal Materials:

Return these forms to BASIC to complete your HSA Renewal:

1. HSA Enrollment Spreadsheet
2. HSA Renewal Wizard

HSA Information for your reference:

• HSA Minimums/Maximums
• HSA Guide for Employers by Larry Grudzien

Enrollment Tools:

• BASIC HSA Guide for Participants
• HSA Enrollment Video
• HSA Eligible Expenses