You will also be provided with an annual statement of your HSA account activity. It will show your account balance at the beginning of the Plan year, contributions deposited to your account, claims paid from your account, deductions due to forfeited amounts, additions from reallocations of forfeited amounts, and the closing balance carried forward into the current Plan year. The beginning year and end year balances will be split into two amounts, Potential Forfeit Balance and Prior Plan Year Balance. The Potential Forfeit Balance is the amount that will be forfeited March 31 of the current Plan year if unused, and only by expenses incurred before the end of the prior Plan year. Prior Plan Year Balance will represent the amount from the prior Plan year that can be carried forward to the current Plan year.
All benefits are non-taxable.
This pamphlet is intended only as a guide and does not establish any legal rights. The accuracy of information contained herein may have changed since the date of publication. For verification, please contact the Plan Administration Office as noted below.