Forms


Click on the links below to download forms for your HSA account.


HSA Application/Enrollment Form


Additional Signatory Authorization


HSA Address Change Request


HSA Account Closure and Withdrawal Request


HSA Beneficiary Designation


HSA Name Change Request


HSA Transfer to UMB from Other Trustee


Employer Contribution Form


Individual Contribution Coupon


Qualified Medical Expenses
Check out what medical expenses qualify for use of your health savings account dollars.


2011 Changes to Qualified Medical Expenses