HSA Resource Center

 

Individual Tools

We have developed a variety of tools to help you get the most out of your HSA.

Eligibility & Contribution Worksheet [PDF]
The Eligibility and Contribution Worksheet helps you determine if you are eligible for an HSA and how much you can contribute.
Qualified Medical Expense Listing [PDF]
This form contains a detailed listing of expenses that are and are not considered Qualified Medical Expenses by the IRS.
Qualified Medical Expense Tracking Worksheet [PDF]
We have developed this simple form to help you keep track of your HSA expenditures by date and participant.
Tax Savings Worksheet [PDF]
Interested in understanding the tax benefits of an HSA? This worksheet was designed to help you estimate the possible federal tax savings you can achieve by contributing to an HSA.
IRA to HSA Worksheet [PDF]
Use this Worksheet to gain a better understanding of the special rules for moving funds from an Individual Retirement Account (IRA) into a Health Savings Account (HSA).
HSA Testing Period Worksheet [PDF]
This worksheet explains the HSA testing period rules.
Distribution Worksheet [PDF]
Use our Distribution Worksheet to better understand the types of permissible HSA distributions and associated tax consequences.