Purchase an HSA eligible, high deductible health plan. For help in finding a qualified plan,
please contact Benefit Administrators or contact your local agent/broker for more information.
STEP 2
You are now ready to open up your Health Savings Account.
Complete Authorization Agreement form here (optional, if electing electronic contributions and/or distributions)
Complete MyRxSavings Enrollment form here (optional, if electing for free prescription discount program)
Include Set up fee
Mail all of the above to:
Benefit Administrators
1009 Oak Hill Road, Third Floor
Lafayette, CA 94549
STEP 3
Fund your Health Savings Account
Individuals may fund the lesser of 100% of their annual health plan deductible or $2900.00. *
Individuals with family coverage may fund the lesser of 100% of the annual health plan
deductible or $5800.00. *
Individuals age 55 and older can make an additional “catch up” contribution of up to $700 for
2008. This amount will increase $100 each year until it reaches $1000 in 2009. A married couple can make two “catch up” contributions as long as both spouses are at least age 55.
Employers and/or individuals can make contributions into an account.
Maximum contribution limits assume coverage by an HSA eligible, high deductible health plan
for the entire year.
Once your account is open, we will send you a welcome kit that includes your account number,
distribution forms, contribution forms and general account information.
