HSA Bank Account
A Health Savings Bank Account (HSA) is an account for eligible members covered under Foth’s medical plan to save for eligible health expenses (medical, prescription, dental and vision). Contributions are made into the account by the member or the company (Outcome-Based Wellness Incentive) and are limited to a maximum amount each year. The account belongs to the member and the funds rollover year to year.
To make HSA contributions and be eligible for the Outcome-Based Wellness incentive, you must be a Foth medical plan participant, must open and be eligible for the Health Savings Bank Account (HSA). You are not eligible for HSA contributions if you are enrolled as a secondary on a non-High Deductible Health Plan, are enrolled in any portion of Medicare, or can be claimed as an IRS tax dependent on someone else’s tax return. Department of the Treasury – HSA Information
Open a HSA Bank Account
Open an HSA Bank Account at either Associated Bank or Optum Bank
*Internal document, must be logged into the Foth network to access
Change your HSA Payroll Contribution Amount
To add or change your HSA payroll contribution amount:
- Non-owners: Go to One Foth homepage > Dayforce > Benefits > “Change or Start HSA Payroll Contribution”. Update your HSA contribution as appropriate, and click “Submit”.
- Owners: Go to One Foth homepage > Dayforce > Forms > Direct Deposit. Click “View/Edit” to edit a current contribution amount or “Add” to add a new contribution. Click “Submit”.
You will receive an email notification after your contribution change is reviewed. Contribution changes generally occur on the next paycheck.
HSA Contribution Limit
| 2021 | Annual Contribution Limit | Additional Catch-up (age 55+) |
| Single | $3,600 | $1,000 |
| Family | $7,200 | $1,000 |
Outcome-Based Wellness Incentive
Foth offers an outcome-based wellness incentive for members/spouses on Foth’s medical plan and eligible for the HSA bank account. The table below shows the annual incentive amount the participating member and spouse will each be eligible to receive (pro-rated), based on their individual Health Assessment score.
The outcome-based wellness incentive counts towards your limit. You must subtract the incentive amount from your limit to calculate the amount that you can personally contribute (either through payroll deduction or a lump sum payment.)
| Health Assessment Score | 86-100 | 71-85 | 61-70 | 0-60 | Scores under 60 with a 5 point improvement over previous year |
| Member Incentive | $1,000 | $500 | $250 | $0 | $250 |
| Spouse Incentive | $1,000 | $500 | $250 | $0 | $250 |
(See current annual contribution limits above)
Associated Bank
Presentation – Maximize Your HSA Dollars by Associated-Bank – February 2018
Associated Bank HSA Plus Account Holder Guide
Transfer funds to Associated Bank – Directly transfer all or part of your HSA from another trustee or custodian to Associated Bank
Learn more about HSA investment options and Open a HSA Investment Account – Associated Bank – For current HSA participants looking to invest a portion of their HSA bank account
– How to Navigate the Investment Portal
Associated Bank – HSA Limited Durable Power of Attorney – Complete to request a second cardholder
Questions? Associated Bank: associatedbank.com, Toll-free HSA Specialist: 1-800-270-7719, Email: ParticipantServices@AssociatedBank.com
Optum Bank
Transfer funds to Optum Bank– Directly transfer all or part of your HSA from another trustee or custodian to Optum Bank
Optum Bank Account Option Comparison – New accounts are defaulted to eAccess. You can contact Optum Bank to switch your account type
Learn more about HSA investing options and Menu of mutual funds
Questions? Optum Bank: Optumbank.com, Toll-free HSA Specialist: 866-234-8913
General Questions
Benefits/Human Resources: Enrollment, plan changes & general benefits inquiries. Benefits@Foth.com
