HSA Information Kit

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An overview of First Horizon Msaver's Health Savings Account program features and benefits.

Employee Information Kit

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An overview of First Horizon Msaver's Health Savings Account program features and benefits for new members of employer offered High Deductible Health Plans.

Enrollment Form

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For use when you have a new enrollee. Submit the Enrollment Form along with a check for the new enrollee(s). Do not include new enrollees on the contribution worksheet. First Horizon Msaver will update your Contribution Worksheet and send it to you once the account is established.

For use when opening a new account for payroll deductions.

Mail In Deposit Form

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Use this form when you mail a check to First Horizon Msaver for contribution to your HSA.

Authorization - Revocation of Authorization To Share HSA Balance Information with PwC

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This form is used to authorize First Horizon to share your HSA balance information with PwC and allow you to view your HSA balance on myKcurve, or to revoke a previous authorization. Complete and return to First Horizon Msaver by fax or mail at the number or address indicated at the bottom of the form.

Authorization To Change Health Savings Account Threshold for Investments

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This form is used to authorize First Horizon Bank to change the amount which must remain in my HSA checking account prior to transferring any funds to other investment options Complete and return to First Horizon Msaver by fax or mail at the number or address indicated at the bottom of the form.

Mail In Deposit Form

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Use this form when you mail a check to First Horizon Msaver for contribution to your HSA.

Request for Transfer to a Health Savings Account Form

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This form is used to transfer funds from another financial institution to a First Horizon HSA.

Distribution Form

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This form is used when you require a distribution from your HSA other than a normal distribution. This includes distributions due to excess contributions, prohibited transactions, transfers to spouse, death, disability or revocation.

Rollover Review Form

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This form is used when you would like to make a rollover contribution. Include this form with the rollover funds so that the contribution is properly coded for tax purposes.

Designation or Change of Beneficiary Form

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This form is used to designate or change beneficiaries.

Add or Remove Authorized Signers Form

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This form is used to add or remove authorized signers to your HSA.

ACH Authorization Form

* This is for Contributions outside of payroll.

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This form is used to set up ACH transactions on your HSA.