Health Savings Account (HSA)
Understanding your
Wells Fargo HSA
Thank you for choosing the Wells Fargo HSA!
We’re here to help you get the most out of your account. If you have any questions about your HSA, don’t hesitate to call Wells Fargo HSA Customer Service at 1-866-884-7374, Monday through Friday from 7:00 a.m. to 8:00 p.m.
Central Time. You can also visit wellsfargo.com/
investing/hsa/toolkit for more tools and resources to help you manage your HSA.
The Wells Fargo HSA
The Wells Fargo HSA consists of a Federal Deposit Insurance Corporation (FDIC)- insured, interest-bearing deposit account and an investment account.
1Your HSA works in conjunction with an HSA-compatible health plan. You can use your HSA to pay for current and future qualified medical expenses
—tax-free.
2Making contributions
The money you contribute to your HSA is tax-deductible and can be used to pay for qualified medical expenses not only for yourself, but also for your spouse and tax dependents.
2You can use the money in your HSA to pay for qualified medical expenses now or save and grow your balance to use later in life or retirement—all tax-free.
You can contribute to your HSA as often as you want throughout the year, up to the annual 2012 IRS limit: $3,100 for individuals or $6,250 for families.
3Individuals age 55 and over may also contribute an additional $1,000 per year in catch-up contributions. The total contributions cannot exceed the annual IRS limit.
You can contribute money directly to your HSA at anytime online through the Wells Fargo Health Account Manager
SMportal. Additionally, you may use the coupon that’s included with your monthly HSA statement or make contri- butions to your account in a Wells Fargo store using a standard account deposit slip. You also
Welcome
may be able to make contributions through automated payroll deductions if your employer offers this service.
To make a one-time contribution or schedule recurring contributions to your HSA, follow these steps:
• Sign on to the Health Account Manager portal at wellsfargo.com/hsa by clicking Sign On next to Access your HSA (use the instructions on the following pages to sign in for the first time).
• Click Contribute to Your HSA from the Quick Links section on the home page or HSA Contributions from the HSA Account Activity page.
Please note: You will need to have your bank account information (account number and bank routing number) from which you are requesting the funds to be debited.
Regardless of how you contribute, it’s impor-
tant not to exceed the maximum annual
contribution limit set by the IRS. If you have
questions on how this limit applies to you,
please consult your tax advisor.
Managing your HSA
You’ll receive a monthly account statement that lists your HSA deposit account balance, invest- ment details, and all transactions, including your HSA debit card transaction details.
1It also includes a year-to-date contribution summary.
Your monthly transaction activity is also available through the Health Account Manager portal. The Health Account Manager portal makes it fast and easy for you to manage your Wells Fargo HSA anytime. It’s a highly secure site that provides all the tools you need to:
• View detailed account activity, including your HSA debit card transactions.
• Maintain your account profile.
• Make a one-time or recurring contribution to your HSA (current or prior year).
• Select automatic transfer to investments. You can turn auto transfer on or off at anytime.
1• View online tax documents and monthly statements, and sign up to eliminate state- ments in the mail—helping us save paper.
• Use online distributions to make one-time transfers into your Wells Fargo bank account.
• View your available balance and investment balance.
1• Order HSA debit cards for your spouse or dependents.
• Download a form to add or update a benefi- ciary to your HSA.
To sign in to Health Account Manager portal for the first time, follow these steps:
1. Go to wellsfargo.com/investing/hsa and click Sign On next to Access your HSA.
2. Click New User Sign On—located on the left side of the page.
3. Enter your Social Security Number and ZIP code.
4. Follow the rest of the steps to create a
username and password.
Qualified medical expenses
To help you determine whether an expense qualifies for tax-free reimbursement under your HSA, Internal Revenue Code Section 213(d) states that eligible expenses must be made for “medical care.” This is defined as amounts paid for the “diagnosis, cure, mitiga- tion, treatment or prevention of disease, or for the purpose of affecting any structure or function of the body.”
Examples of common qualified medical expenses include:
• Acupuncture
• Ambulance services
• Artificial limb or prosthesis
• Dental treatment
• Contact lenses
• Doctor’s fees
• Hearing aids and hearing aid batteries
• Hospital services
• Laboratory fees
• Lactation assistance supplies
• Prescription medicines or drugs
• Nursing home
• Nursing services
• X-rays
As of January 1, 2011, expenses for over-the- counter (OTC) drugs are no longer eligible for payment or reimbursement from an HSA without a doctor’s prescription. This change is a result of the 2010 healthcare reform legisla- tion. A few examples of OTC medicines that will require a doctor’s prescription for payment or reimbursement from an HSA are:
• Cold, cough, and flu medications
• Allergy and sinus medications
• Pain relief medications
• Acid controllers
• Sleep aids and sedatives
You should save your receipts and doctor’s prescriptions for OTC medicines for tax purposes. Insulin and prescribed drugs will continue to be eligible for payment or reim- bursement from an HSA.
Qualified medical expenses are eligible for reimbursement through your HSA if they are not reimbursed through insurance or other sources. As the HSA owner, you are respon- sible for determining whether a healthcare expense is eligible for reimbursement from your HSA.
For more information about qualified medical
expenses, please visit wellsfargo.com/hsa or
call Customer Service.
Accessing funds in your HSA
There are several ways to access your HSA funds. You can:
• Use your Wells Fargo Visa
®HSA debit card to make purchases at any merchant that accepts Visa debit cards.
• Visit more than 6,000 Wells Fargo stores to make deposits, withdrawals, and transfers.
• Make free withdrawals at more than 12,000 Wells Fargo ATMs nationwide.
• Make withdrawals at any ATM displaying the Visa or Plus
®logos worldwide.
• Pay for qualified medical expenses using cash or your personal credit/debit card. Then, reimburse yourself by making a withdrawal from your HSA at an ATM or at a Wells Fargo store using your HSA debit card. You also can send in a reimbursement request to pay yourself back by check or electronic deposit.
• Use online distributions through the Health Account Manager portal to make one-time transfers into a Wells Fargo bank account that is in your name.
• Provide the doctor or merchant with your HSA debit card number to pay for a product or service.
• Use HSA checks to pay merchants for qualified medical expenses. (To order checks for your HSA, please call Customer Service.
Note that an additional fee applies.)
Your HSA debit card
You will receive your HSA debit card and personal identification number (PIN) in three to seven business days in separate mailings.
Please activate your HSA debit card as soon as you receive it. To order debit cards for your spouse or dependents, visit the Health Account Manager portal.
Your HSA debit card makes it easy and convenient to access your HSA funds. Your HSA debit card is tied to the current deposit account balance in your HSA (the available balance or cash balance—not what is invested in mutual funds). It can be used to pay for qualified medical expenses billed from an insurance company, at a doctor’s office or pharmacy, or at any merchant that accepts the Visa debit card. In addition, you can use your HSA debit card to make ATM withdrawals.
It’s important to remember that it’s your responsibility to determine which expenses are qualified medical expenses, and to only use your HSA debit card to pay for qualified medical expenses. Always save your receipts.
Please read the Debit Card Terms of Use that will be enclosed with your new HSA debit card for details about daily spending limits and other important information regarding purchases and ATM cash withdrawals.
The HSA debit card is backed by the Zero
Liability program that safeguards accounthold-
ers from loss if unauthorized card transactions
are reported promptly and in accordance with
the procedures in the Health Savings Account
Custodial Agreement and Debit Card Terms of
Use.
Your HSA investment account
1Wells Fargo offers the ability to invest in a diverse array of mutual funds to meet a variety of investing goals and objectives. An overview of the mutual funds is available at wellsfargo.com/
hsa. There are no setup fees, no transaction fees, and the front-end loads for the mutual funds are waived for HSA accountholders.
You have the option to invest HSA balances over $2,000 in mutual funds or choose to keep the funds above $2,000 in the FDIC-insured deposit account. To activate your investment account, follow the steps below. At any time, once your investment account is set up, you can establish your investment elections. When your balance exceeds $2,000, your money in excess of $2,020 ($20 is the minimum transfer amount) will automatically be directed into the mutual funds of your choice.
You can activate your investment account through the Health Account Manager portal at wellsfargo.com/hsa:
• Click Sign On next to Access Your HSA to sign on.
• Choose HSA Account Activity.
• Choose HSA Investments.
• Click Activate HSA Investment Account.
You can also turn off the auto transfer function- ality by following these steps. You should turn off the auto transfer when moving money back to your deposit (or cash) account to access it on the debit card.
• Select the HSA Investment Account Page
• Click Edit Automatic Transfers to Investment Account Status Page
• Update the Automatic Transfers to Investment Account preference and click Save
Note: Updates to Automatic Transfers can only be completed between the hours of 6:00 a.m.
and 10:30 p.m. Central Time.
After you have activated your investment
account, you can set up your investment
elections through the Health Account Manager portal.
• Go to wellsfargo.com/hsa and click Sign On next to Access Your HSA to sign on.
• Choose HSA Account Activity.
• Choose HSA Investments.
• Click the Access HSA Investments button, which will take you to the Wells Fargo Retirement Plan page. You will need to sign on with your investment account username and password. (If you are a first-time user on the Wells Fargo Retirement Plan page, your investment account username is your Social Security Number, and your password is your date of birth in MMDDYYYY format.)
• Select the Wells Fargo Health Savings Account Plan.
• Under the Transactions and Forms tab, select Manage Investments then Redirect Future Elections only.
Note that you can follow the steps above to
change or transfer your investment elections
anytime.
How can we help?
Thank you for your business.
We look forward to helping you meet your financial goals.
If you have questions about your HSA, call Customer Service at 1-866-884-7374 Monday through Friday from 7:00 a.m. to 8:00 p.m.
Central Time.
Or, visit wellsfargo.com/
investing/hsa/toolkit for more helpful tools and resources.
Health Benefit Services, A Division of Wells Fargo Bank, N.A.
© 2011 Wells Fargo Bank, N.A. All rights reserved.
MC-1777 8/11
2 Tax references at the federal level. State taxes may vary. Please consult a tax advisor.
3 These are the IRS contribution limits for 2012. Individual contribution limits may vary. If you have questions about your individual limit, please consult your tax advisor.
1 INVESTMENT PRODUCTS: NOT FDIC INSURED • NO BANK GUARANTEE • MAY LOSE VALUE
