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Account Details
Fees Associated with an HSA Account

     Initial Set-Up

$25.00

     Monthly Maintenance

$3.95

     Disbursement   (ACH)

FREE

     Disbursement   (Check)

$5.00

     Statement (Mailed)

$3.00

     Statement (Online)

FREE

     Account Termination

$25.00

     Debit Card–Primary Card
     (Optional) Monthly recurring

 $5.00

     Debit Card–Secondary Card (Optional)      Monthly recurring

$3.00

     Investment Account (Optional)
     Portfolio Annual Fee

$36.00

     Trade Fee

$3.95

     Claims Vault Storage
     Monthly recurring

$2.00



 

 

 

 

 

 

 

 

 



Current Interest rates  *(Subject to change)

$100.00 balance required at all times.

      Up to $500.00

0.0%

      $501.00 - $2,000.00

1.5%

      $2,001.00 - $2,500.00

2.0%

      $2,501.00 - $5,000.00

2.25%

      $ 5,001.00 - $10,000.00

2.75%

      $10,000.00 +

3.25%








 

*All fees to be deducted from the HSA/MSA.

*Investment account requires a $2,500 minimum balance in the HSA/MSA before       participating.

MyRxSavings Prescription Discount Program

This value-added feature offers accountholders free access to prescription discounts at over 54,000 pharmacies nationwide, including a mail order service. Click here for more information.

Medical Expense Reimbursement Procedures

To receive a medical reimbursement from the HSA account, you will need to submit a Distribution request form. This can be faxed or mailed to Benefit Administrators. You have two options for receiving a distribution. You may request for Benefit Administrators to mail you a check or have the funds transferred directly into your personal bank account (ACH Option).


Bank Statements

There is no charge for viewing and printing statements online, however, there will be a $3.00 charge for mailed statements.



Rollovers

In order to transfer or rollover a previous MSA or HSA account you will need to complete the HSA Rollover/Transfer Form and send it to Benefit Administrators. We will then forward to the receiving custodian for the rollover to be executed.



Additional Account Information

For more information on these accounts please see the attached Custodial and Disclosure Agreements.