Apply Now for Employers

Step 1 -

You are on your way to tax savings!

Please complete the following application and submit.

Company Application

In order to deduct pre-tax contributions for an HSA you as an employer must also have adopted a Section 125 Plan before those contributions are deducted. If you do not already have that plan in place we can help you with that. In order to implement a Section 125 Plan you must have a written Plan Document and Summary Plan Description that is kept up-to-date and certain discrimination testing must be performed.

Step 2 –

After you submit your application above, we will set-up your corporate account and contact you within 3 business days. You will receive:

  • Your company Employer Code,
  • Instructions for your employees to sign up (everything they need is on our Apply Now for Employees page).
  • Information on any additional requested services.

Step 3 –

Distribute to your employees instructions for application along with your Employer Code.

They will complete the HSA application online. If they desire payroll deduction, they will print, complete and submit an HSA Salary Reduction Agreement. Employees will submit this form to your designated HR individual. We will also need a copy of each form for our records.

You (the employer) will then fax the HSA Salary Reduction Agreement to YourFlex at:
(804) 379-5898

Step 4 –

Within 30 days of the account effective date, the contact person named on your company application will be emailed our bill for administrative fees. From that point forward we bill annual administrative fees a month before your annual renewal date (included on your company application). Our fee is $42/account for a 12 month time-period. Any time-period less than that will be prorated at $3.50/month for each employee who signed up for an account.

After billing we allow 3 weeks for your review. Then we will ACH your designated checking account for the total on the bill.

New employees can sign up all year long. Billing will be handled the same way as described above.

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