• New HSA Application Form
• Brochure
• Rollover Form (Rolling over a MSA in CA is a taxable event, Please contact us if you have any questions.)

New Health Savings Account Processing 

• Gilmore Bank will process your HSA application and send a welcome letter and signature cards via mail, usually within 7 days from the time your application is received.
• You must sign and return the signature cards included in the welcome packet to the bank.  Accounts are not activated and deposits are not available until signature cards are returned to the bank.
• Your debit card and PIN number will arrive separately approximately 10 days after you receive the signature cards and welcome letter.

If you're 55 to 65 don't forget you can fund your account with a extra $900 for 2008.

If you have any questions, please email us at info@hsaclearing.com   or call toll free 1-866-HSA-4721

IRA to HSA Rollover Form

A one-time tax-free trustee-to-trustee transfer of IRA funds to an HSA is permitted. The amount transferred may not exceed your maximum allowable annual HSA contribution (for example, $5,800 for those with family coverage in 2008). Any money transferred from your IRA counts toward your maximum HSA contribution for that tax year. You may not transfer a "Catch-Up" contribution. You must maintain your HSA-qualified health plan coverage for the entire calendar year for which you are making the transfer or your HSA contribution (including IRA rollovers) will be limited further. You may not take the usual tax deduction for HSA contributions for any funds transferred from your IRA and contributed to your HSA. However, once the IRA funds are deposited in the HSA, they may be used tax-free for qualified medical expenses. Had the funds remained in the IRA, the amount withdrawn would be subject to income tax (and a 10% penalty if withdrawn before age 59-1/2)