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Thomaston Savings Bank
Health Savings Account Enrollment Instructions
·
After reviewing these instructions, please
select the link at the bottom
of this page to open your account at our HSA
Service Center.
·
Select the link to Open an HSA
from the HSA
Service Center home page.
·
General Information
o
Complete all personal information
fields.
o
Select
Make a Contribution to an HSA.
o
Select
Continue.
·
Select Investment
o
Select the box that corresponds to
the amount of your
contribution.
o
Enter the amount of the
contribution in the Amount box.
o
Select
Continue
· Naming Your Beneficiaries
o
Complete all Primary and
Contingency Beneficiary (if
applicable)
information fields.
o
Verify that the total of designated
percentages is 100%.
o
Select Continue.
· Review and Print
o
Select the link to review
the general, investment and
beneficiary information you entered.
o
Select the link to access
printable versions of required HSA
forms.
§
Icons for HSA Forms 3410 and 3500
will display on
the left of the screen.
§
Select the HSA Form 3410 icon to
review and print
the HSA Contribution/Investment Form. The
print
icon is located in the upper right corner of the form.
§
Select the HSA Form 3500 icon to
complete the
Thomaston Savings Bank HSA
Enrollment form.
After
completing the HSA Enrollment, please review
and print the form,
related disclosures and HSA
Form 3500. Step by step
instructions are also
provided on the HSA Enrollment. The print
icon is
located in the upper right corner of the HSA
Enrollment
Form.
o
Select Close Window to
return to the previous screen.
o
Select Submit at the bottom
of the screen to finalize your
enrollment.
· You have completed the enrollment process and may
exit the
Thomaston
Savings Bank online HSA Service Center.
· Remit Printed Forms and Contribution
o
Sign and date the following printed
HSA forms.
§
HSA Form 3410
§
HSA Form 3500
§
Thomaston Savings Bank HSA
Enrollment. This form
must also be signed by the designated
authorized
signer, if any.
o
Mail the completed forms
(total of 4 pages)
and your
contribution check to Thomaston Savings Bank, HSA
Dept, P.O.
Box 907, Thomaston, CT 06787. You may also bring
these items
to any branch of Thomaston Savings Bank.
o
Please to not remit disclosures.
· Retain Copies
o
Keep a copy of your signed forms
and disclosures for your
records.
· Watch Your Mail
o
Your Health Savings Account will be
established upon our
receipt of required enrollment forms and
initial contribution.
o
You will receive a Welcome Letter
containing information on your
new HSA.
o
HSA Visa Check Card or checks, if
requested, will be shipped
separately.
Thomaston Savings Bank HSA Service Center
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Copyright 2008
Thomaston Savings Bank. All rights reserved.
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