SEFCU - Open an HSA now.

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Opening a Health Savings Account (HSA) with SEFCU is quick and easy. Just bring completed paperwork to one of our many branch locations.

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Already a SEFCU member?

SEFCU members can open an HSA by completing the following forms:

HSA Eligibility and Information
Use this form to determine your eligibility to open an HSA.
Health Savings Account Application
Use this form to open an HSA.
Contribution Form
Use this form to make a contribution to your HSA.
Authorized Signer Agreement (Optional)
There can be only one owner of an HSA. If you would like for your spouse or third party to transact on the HSA, you will need to complete this form.
Designation of Beneficiary(ies) (Optional)
If you wish to designate beneficiaries to your HSA, please complete this form.
Transfer/Rollover Request Form (Optional)
Complete this form if you currently have a Medical Savings Account (MSA), Flexible Spending Account (FSA), or an HSA with another custodian and want to roll those funds over to your HSA at SEFCU.
Health Savings Account Transfer Form (Optional)
Use this form to move HSA assets from another financial organization to your HSA at SEFCU.

In addition, please note the need for the following to successfully open an HSA:

Have your Social Security Number or Individual Taxpayer Identification Number handy. You must have a valid driver’s license or state-issued ID available.
If there will be an additional signer (authorized user) on the account, then that person should be present, or you will need to know his/her personal information, including Social Security Number.
Your authorized user can be granted a Visa^® debit card and checks with his/her name linked to your account.
You have several options to fund your HSA:
1. Make a contribution (deposit) at a SEFCU branch
2. Transfer funds from a SEFCU account (existing member only)
3. Mail a check or certified money order to SEFCU (existing Health Saving Accounts only)

There is a minimum balance of $25.00 required for SEFCU membership. This must be deposited into a Mint Savings account (which will be created if you are a new member), in order for membership to be established. There is no minimum balance or deposit required to open your HSA Checking account, however, there is a minimum opening balance requirement of $500.00 for HSA Share Certificates. If funds are not deposited into the HSA Checking account within 45 days, the account will be closed.

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