№ lp_1_2_64510
This is a formal employee certification record defining eligibility conditions for employer contributions to a Health Savings Account under U.S. federal tax law and qualified high-deductible health plans.
Year: 2020
Document type: Employee certification form
Subject: Health Savings Account eligibility
Health plan type: HSA-compatible CDHP
Governing law: Internal Revenue Code §223(c)(2)
Related programs: VEHI Gold CDHP, VEHI Silver CDHP
Parties involved: Employer, Employee
Required action: Employee certification and notification of eligibility changes
Signature required: Yes
Referenced authority: Internal Revenue Service
Coverage categories: Self-only coverage, Family coverage
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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