THE DISTRICT CONTRIBUTES FUNDS INTO THE EMPLOYEE’S HSA FOR LICENSED PARTICIPATING EMPLOYEES. THERE IS NO CONTRIBUTION FOR CLASSIFIED EMPLOYEES, IT IS EMPLOYEE ONLY CONTRIBUTIONS.

TO ENROLL IN THE DISTRICT’S HSA PLAN, YOU MUST BE ENROLLED IN THE MODA MEDICAL PLAN 6 OR KASIER MEDICAL PLAN 3.

YOU CANNOT ENROLL IN AN HSA THE SAME CALENDAR YEAR YOU HAVE/HAD A HEALTH FLEXIBLE SPENDING ACCOUNT (FSA). ANY ROLLOVER FROM AN FSA FROM ONE YEAR TO THE NEXT WILL DISQUALIFY YOU FROM ENROLLING IN AN HSA FOR THAT YEAR. PLEASE BE CAREFUL TO NOT HAVE ANY REMAINING ROLLOVER FROM AN FSA IF YOU PLAN TO ENROLL IN AN HSA FOR THAT YEAR.

FAQS ABOUT THE AMERICAN FIDELITY ASSURANCE (HSA) THAT DDSD PROVIDES FOR EMPLOYEES TO ENROLL IN.

IRS PUBLICATION 969 – INFORMATION FROM THE IRS ABOUT HSA’s

Forms to enroll or change the amount you are contributing to your HSA.

• ENROLLMENT FORM FOR THOSE WHO DO NOT HAVE AN HSA SET UP WITH DDSD
• CHANGE FORM FOR THOSE WHO ARE CURRENTLY ENROLLED WITH AN HSA ACCOUNT, BUT WOULD LIKE TO CHANGE THE AMOUNT THEY ARE CONTRIBUTING