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ENROLLMENT INSTRUCTIONS

Start saving for your future medical expenses today with a Blue Healthcare Bank Health Savings Account (HSA).

High-deductible health plans offer many advantages, including the ability to open a Health Savings Account.
An HSA can cover qualified healthcare expenses not covered by your health plan, including your deductible and other out-of-pocket expenses.

Getting Started
To open your account and start saving, just fill out the application. It will only take a few minutes to complete; just follow the simple steps below. Everything you will need is included here.

Step 1: Complete and sign the Health Savings Account Application.

Step 2: Mail your completed application to: Blue Healthcare Bank, P.O. Box 610, Williamsville, NY 14231.

Your HSA
After we receive and process your complete application, an HSA will be opened in your name. This account belongs to you. The balance of your account is insured by the Federal Deposit Insurance Corporation (FDIC), subject to FDIC rules. (Note: Amounts you transfer into an investment account are no longer FDIC-insured.) Information regarding your account will be sent directly to you from Blue Healthcare Bank.
Blue Healthcare Bank will send you a welcome kit, including:

• Your account number
• Deposit Account Agreement and Account Disclosures
• Truth in Savings Disclosure with Schedule of Fees
• Privacy Policy for Blue Healthcare Bank
• A set of starter checks and deposit slips

Your Blue Healthcare Bank Debit Card will be sent to you in a separate mailing.

To make deposits through a payroll deduction, check with your employer for availability and requirements.