Health Savings Account Information

Health Savings Account

A Health Savings Account (HSA) is different and separate from your insurance. It is an account you set up at a financial institution (click here for information on vendor options) and it belongs to you during and after your employment with the district. Because deposits into the Health Savings Account are not taxed, the IRS regulates how much you may contribute and how you may spend it. The primary rule is that in order to get the tax advantage of an HSA you must also be enrolled in a health plan that has a high deductible (as defined by the IRS.) After money is contributed to the HSA you are able to spend it on qualifying medical expenses. The goal is to grow your account over time and save money on your insurance costs as the high deductible medical plans are less expensive than the other plans.

The Moda Plan 6, Moda Plan 7 and Kaiser Plan 3 are health insurance options available to employees and retirees for the 2019-2020 coverage year and qualify as HSA compliant medical plans. These medical plans are the lowest priced plans available from OEBB, and also have the highest deductibles. The maximum amount that may be contributed into a HSA each year is listed below. That amount includes both the employee and employer contribution. Your personal contribution amount may be changed at any time during the year. There is no maximum amount that may be spent for medical expenses for you and your tax dependents.


In order to qualify you must establish that you are not:

1) Being claimed as a dependent on another person's tax return,

2) Covered by any other health plan other than a qualified High Deductible Health Plan or

3) Enrolled in Medicare.

HOW IT WORKS: Employees may select the Moda Plan 6, Moda Plan 7 or Kaiser Plan 3 with or without dental and/or vision. If the combined cost of your choice of medical, dental and vision plans is less than the district contribution for your employee group, the district will deposit the difference (savings) into your Health Savings Account automatically. If you are generally healthy and have very few medical expenses, that money will continue to accrue year after year. It is not a use it or lose it plan like the Medical Flexible Spending Account.

If you used a HSA account last year, the district will assume you want to contribute to the same account this year. However, if this is the first time you are enrolling in a high deductible plan and you or the district will be making contributions you will need to open a Health Savings Account and turn the enrollment form into the payroll department before the payroll cutoff date. Otherwise we will just hold your contribution until you turn your form in. Most financial institutions offer debit cards to access your HSA and you do NOT need to submit receipts to the bank. (However you are accountable to the IRS, so you may want to keep receipts at home in case you are audited in the future.) If you would like to open an account with American Fidelity or Optim/U.S. Bank please complete one of the forms below and turn it in to the payroll office. If you prefer to open an account with your own bank, you must first visit your bank to open an account, then be sure to complete the appropriate form below for your payroll office.

In order to receive contributions from the district and/or make contributions of your own into a Health Savings Account you much first open an account then complete the HSA Deduction Form below and turn it into the Payroll Department.

If your Health Savings Account is at a financial institution other than Optim/US Bank or American Fidelity you will also need to complete the HSA Direct Deposit Authorization Form below and turn it in to the Payroll Department.

CURRENT MEDICAL FLEXIBLE SPENDING ACCOUNT (FSA) PARTICIPANTS: If you are contributing into a FSA plan now, and choose to open a HSA, you need to know the IRS again has rules regulating your tax liability. The IRS will NOT allow you to have money in a FSA while also contributing to a HSA. This is very important because on the last day of your FSA plan year (December 31) you must not have any money remaining in your FSA. The district will "hold in trust" your HSA contributions during the run out period for your FSA (January if your Flex dollars were used up in time, or 90 days into the new year if you had even $0.01 in your Flex). Please contact American Fidelity if you have any questions at all about coordinating a smooth transition from FSA to HSA.


  • $3,500 Individual
  • $7,000 Family
  • $1,000 "Catch-up" contribution for participants who are age 55 or older.


  • $3,550 Individual
  • $7,100 Family
  • $1,000 "Catch-up" contribution for participants who are age 55 or older.

HSA Forms to be Completed and Submitted to the Payroll Office

Information on where to go to set up a Health Savings Account

American Fidelity HSA Application – to open a Health Savings Account with American Fidelity.

Optim/US Bank HSA Application – to open a Health Savings Account with Optim/US Bank.

HSA Direct Deposit Authorization Form – if you open a Health Savings Account at any other financial institution other than the two listed above.

HSA Payroll Deduction Form – for all Health Savings Accounts to be completed once account is open.