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Health Savings Account

You have established a high deductible health plan ("HDHP"), which is paired with a health savings account ("HSA") plan, for the benefit of your eligible employees who are participating in the HDHP.

Each such eligible employee who participates in your HSA plan offering will be required to enter into an Accountholder Agreement as well as other agreements including, but not necessarily limited to, an HSA Adoption Agreement, Custodial Account Agreement, Disclosure Statement, and HSA Deposit Account Terms, Conditions and Disclosures, directly with the third party custodian bank that you have selected to hold the employees' HSA funds.  The custodian bank has the right to charge fees and other amounts to each individual HSA accountholder and, with appropriate notice to such individual HSA accountholder, to make changes to the custodian bank's accountholder fee schedule and any other terms and conditions contained in any of their documents if and when the custodian bank deems it appropriate. 

For clarification, HSA custodian banks are not subcontractors of WageWorks and the Accountholder Agreement between a custodian bank and each individual HSA accountholder controls the terms under which the HSA is maintained by the custodian bank, including the rights of the custodian bank to charge fees or other amounts to individual HSA accountholders for managing the HSAs.


  1. Client's Responsibilities
    As the plan sponsor, you are liable for the design, funding and operation of your Plan ("Plan") including compliance with IRS Code Section 223. You shall:
    1. Select a custodian for your Plan from our list of approved custodians.
    2. Require your employees to complete enrollment procedures to open an HSA.
    3. Determine if an employee is eligible to contribute to an HSA.
    4. Electronically identify salary reductions and employer contributions for each individual.
    5. Limit salary reduction HSA contributions to the maximum specified annually by the IRS.
    6. Provide accountholders with all applicable notices, forms and disclosures, including those provided by the custodian or us.
    7. For batch-file enrollment, execute a hosting agreement with the custodian and post terms and conditions on your benefits portal, if applicable.
    8. Provide us with information that we request with respect to each accountholder.
    9. Provide us with completed forms and notices needed to transfer accountholders with existing HSAs from their current custodian to a new one.
    10. Represent and guarantee that accountholder information and enrollments are accurate and complete.
    11. Remit to us the funds to be deposited into each HSA accompanied by data that accurately indicates the credit amount to be applied to each account.
    12. Provide benefits funding pursuant to the terms of the Funding Agreement.
    13. Accept full liability for any funds not received by us, or for any errors in crediting an HSA based on false or incorrect data provided by you or an accountholder.
    14. Assume full responsibilities for HSA accountholder information that you have provided to us to administer the HSAs, including costs and expenses for error correction.
    15. Provide no further limitations beyond the restrictions imposed by the IRS Code for beneficiaries moving or using their HSA funds.
    16. Timely pay all service fees.
    17. Represent:
      • Your employee data has been positively identified either by IRS I-9 forms or upon your review of your beneficiaries' government-issued documentation as evidence of nationality or residence; and
      • Your employees have certified their authorization to work in the United States and provided social security numbers or taxpayer ID numbers, which you will provide us for the purpose of establishing HSAs.
  2. WageWorks' Responsibilties
    We have been engaged by you to perform certain recordkeeping and administrative services in connection with your Plan.  We shall:
    1. Provide data and file integration with your HSA custodian.
    2. Provide a set of electronic file specifications for you to use in delivering data to us.
    3. Provide standard HSA materials and forms, including HSA applications and information brochures, required by the HSA custodian for viewing and download via an accessible website.
    4. Upload and post contribution files after your payroll contributions are completed.
    5. Allocate contributions to pay applicable administrative and account maintenance fees for the HSAs.
    6. Work with you to correct inaccurate and mistaken HSA contributions to the extent practicable under IRS Code Section 223 and all other applicable regulations.
    7. Provide accountholders with access to their HSA balance through our Card Services, Bill Payment Services, and online withdrawal requests via the website.
    8. Make rollover distributions to a new trustee or custodian.
    9. Provide for viewing and download the following reports: enrollment report, invoice report, HSA contribution funding report, HSA pending and expired contribution report, and HSA termination report.
    10. Close an HSA upon the instructions of the accountholder.
  3. Custodian's Responsibilities
    1. Determine if an HSA is in an open status and if contributions can be posted to the HSA.
    2. Provide individual participants with Accountholder Agreements as well as other agreements including, but not necessarily limited to, an HSA Adoption Agreement, Custodial Account Agreement, Disclosure Statement, and HSA Deposit Account Terms, Conditions and Disclosures, outlining the fees and charges that the custodian may charge such individuals directly for administering their accounts or otherwise and advising such individuals that such fees are subject to change as outlined in their individual Accountholder Agreements and other agreements provided directly to the participant.
    3. Provide confirmations for funds remitted by you.
    4. Deposit funds remitted by you into the HSAs.
    5. Invest the funds in the HSAs, pursuant to the allocations designated by the accountholders.
    6. Provide account statements to accountholders.
    7. For purposes of account funds rollover, facilitate the transfer of HSA funds into or out of the accountholder's account at the instruction of the accountholder.
    8. Ensure accuracy, completeness, legality, timeliness or other compliant status of any data provided to us.
    9. File any Form 1099-SA (or equivalents) with the IRS and distribute Forms 1099-SA and 5498-SA to account holders.


 (V 3/30/18)