Term$.01 - $4,999.99 $5,000 - $24,999.99 $25,000 - $49,999.99 $50,000 and greater | Interest Rate0.40% 1.19% 1.98% 2.52% | Annual Percentage Yield0.40% 1.20% 2.00% 2.55% |
Rate Information – The interest rate and annual percentage yield are a monthly variable and may change at our discretion.
Compounding Frequency – Interest will be compounded monthly.
Crediting Frequency – Interest will be credited into this account monthly.
Daily balance computation method – Interest is calculated by the daily balance method which applies a daily periodic rate to the balance in the account each day.
Accrual of Interest on Noncash Deposits – Interest will begin to accrue no later than the business day we receive credit for the deposit of noncash items (for example, checks) into your account.
Minimum Balance to Open – The minimum balance required to open this account is $25.00.
Minimum Balance to Avoid a Fee – If your balance falls below $500.00 on any day in the month, your account will be subject to a $3.00 ACCOUNT MAINTENANCE FEE for that month.
Deposit Limitations – You may make an unlimited number of deposits into your account.
Fees and Charges – The following fees and charges apply to this account:
FOREIGN ATM DEBITS: There is a charge of $1.50 per withdrawal at ATMs not owned by our bank after the first three withdrawals per month.
ATM BALANCE INQUIRY: There is a charge of $1.50 per inquiry at ATMs not owned by our bank.
Additional Terms
Your Ability to Withdraw Funds
This policy statement applies to “transaction” accounts. Transaction accounts, in general, are accounts which permit an unlimited number of payments to third persons and an unlimited number of telephone and preauthorized transfers to other accounts of yours with us. Feel free to ask us whether any of your other accounts might also be under this policy.
Our policy is to make funds from your cash and check deposits available to you on the first business day after the day we receive your deposit. Electronic direct deposits will be available on the day we receive the deposit. Once the funds are available, you can withdraw them in cash and we will use the funds to pay checks that you have written.
Please remember that even after we have made funds available to you and you have withdrawn the funds, you are still responsible for checks you deposit that are returned to us unpaid and for any other problems involving your deposits.
Determining the Availability of a Deposit
For determining the availability of your deposits, every day is a business day, except Saturdays, Sundays, and federal holidays. The length of the delay is counted in business days from the day of your deposit. If you make your deposit prior to 4:00 pm at our Lincoln Branch; 4:00 pm at our Motor Bank and 4:00 pm at our Main Bank, Monday through Friday on a business day that we are open, we will consider that day to be the day of your deposit. However if you make a deposit at the Lincoln Branch after 4:00 pm, the Motor Bank after 4:00 pm or the Main Bank after 4:00 pm, Monday through Friday or on a day we are not open, we will consider that the deposit was made on the next business day that we are open. If you make a deposit at an ATM before 6:00 pm on a business day that we are open, we will consider that day to be the day of your deposit. However, if you make a deposit at an ATM after 6:00 pm or on a day we are not open, we will consider that the deposit was made on the next business day we are open.
If we cash a check for you that is drawn on another bank, we may withhold the availability of the corresponding amount of funds that are already in one of your accounts. Those funds will be available at the time funds from the check we cashed would have been available if you had deposited it.
If we accept for deposit a check that is drawn on another bank, we may make funds from the deposit available for withdrawal immediately but delay your availability to withdraw a corresponding amount of funds that you have on deposit in another account with us. The funds in the other account would then not be available for withdrawal until the time periods that are described elsewhere in this disclosure for the type of check that you deposited.
Longer Delays May Apply
Case-By-Case Delays – In some cases, we will not make all of the funds that you deposit by check available to you on the first business day after the day of your deposit. Depending on the type of check that you deposit, funds may not be available until the second business day after the day of your deposit. The first $200 of your deposits, however, may be available on the first business day.
If we are not going to make all of the funds from your deposit available on the first business day, after we receive your deposit, we will notify you at the time you make your deposit. We will also tell you when the funds will be available. If your deposit is not made directly to one of our employees, or if we decide to take this action after you have left the premises, we will mail you the notice by the first business day after we receive your deposit.
If you will need the funds from a deposit right away, you should ask us when the funds will be available.
Safeguard Exception Delays – Funds you deposit by check may be delayed for a longer period under the following circumstances:
We will notify you if we delay your ability to withdraw funds for any of these reasons, and we will tell you when the funds will be available. They will generally be available no later than the seventh business day after the day of your deposit.
Deposits at Automated Teller Machines
Funds from any deposits (cash or checks) made at Automated Teller Machines (ATMs) we do not own or operate will be available on the fifth business day after the day of deposit. All ATMs that we own or operate are identified as our machines.
Special Rules for New Accounts
If you are a new customer, the following special rules will apply during the first 30 days your account is open.
Funds from electronic direct deposits to your account will be available on the day we receive the deposit. Funds from deposits of cash, wire transfers, and the first $5,000 of a day’s total deposits of cashier’s, certified, teller’s, traveler’s, and federal, state and local government checks will be available on the first business day after the day of your deposit, if the deposit meets certain conditions. For example, the checks must be payable to you (and you may have to use a special deposit slip). The excess over $5,000 will be available on the ninth business day after the day of your deposit. If your deposit of these checks (other than a U.S. Treasury check) is not made in person to one of our employees, the first $5,000 will not be available until the second business day after the day of your deposit.
Funds from all other check deposits will be available on the seventh business day after the day of your deposit.
Your Rights and Responsibilities
Indicated below are types of Electronic Fund Transfers we are capable of handling, some of which may apply to your account. Please read this disclosure carefully because it tells you your rights and obligations for the transactions listed.
Electronic Fund Transfers Initiated By Third Parties – You may authorize a third party to initiate electronic fund transfers between your account and the third party’s account. These transfers to make or receive payment may be one-time occurrences or may recur as directed by you. These transfers may use the Automated Clearinghouse (ACH) or other payments network. Your authorization to the third party to make these transfers can occur in a number of ways. In some cases, your authorization can occur when the merchant posts a sign informing you of their policy. In all cases, the transaction will require you to provide the third party with your account number and financial institution information. This information can be found on your check as well as on a deposit or withdrawal slip. Thus, you should only provide your financial institution and account information (whether over the phone, the Internet, or via some other method) to trusted third parties whom you have authorized to initiate these electronic fund transfers. Examples of these transfers include:
Documentation
Terminal Transfers – You can get a receipt at the time you make any transfer to or from your account using one of our automated teller machines or point-of-sale terminals.
Preauthorized Credits – If you have arranged to have direct deposits made to your account at least once every 60 days from the same person or company, you can call us at (402)643-3636 to find out whether or not the deposit has been made.
Periodic Statements – You will get monthly account statement from us for your checking account(s). You will get a monthly statement from us for your savings account(s), unless there are no transfers in a particular month. In any case, you will get a statement at least quarterly.
Preauthorized Payments
Right to Stop Payment and Procedure for Doing So – If you have told us in advance to make regular payments out of your account, you can stop any of these payments. Here is how:
Call or write us at the telephone number or address listed in this disclosure in time for us to receive your request three business days or more before the payment is scheduled to be made. If you call, we may also require you to put your request in writing and get it to us within 14 days after you call.
Notice of Varying Amounts – If these regular payments may vary in amount, the person you are going to pay will tell you, 10 days before each payment, when it will be made and how much it will be. (You may choose instead to get this notice only when the payment would differ by more than a certain amount from the previous payment, or when the amount would fall outside certain limits that you set).
Liability for Failure to Stop Payment of Preauthorized Transfer – If you order us to stop one of these payments three business days or more before the transfer is scheduled, and we do not do so, we will be liable for your losses or damages.
Financial Institution’s Liability
Liability for Failure to Make Transfers – If we do not complete a transfer to or from your account on time or in the correct amount according to our agreement with you, we will be liable for your losses or damages. However, there are some exceptions. We will not be liable, for instance:
Confidentiality
We will disclose information to third parties about your account or the transfers you make:
Unauthorized Transfers
(a) Consumer Liability – (1) Generally, tell us AT ONCE if you believe your card and/or code has been lost or stolen or if you believe that an electronic fund transfer has been made without your permission using information from your check. Telephoning is the best way of keeping your possible losses down. You could lose all the money in your account (plus your maximum overdraft line of credit). If you tell us within two business days, you can lose no more than $50 if someone used your card and/or code without your permission. (If you believe your card and/or code has been lost or stolen, and you tell us within two business days after you learn of the loss or theft, you can lose no more than $50 if someone used your card and/or code without your permission).
If you do NOT tell us within two business days after you learn of the loss or theft of your card and/or code, and we can prove we could have stopped someone from using your card and/or code without your permission if you had told us, you could lose as much as $500.
Also, if your statement shows transfers that you did not make, tell us at once. If you do not tell us within 60 days after the statement was mailed to you, you may not get back any money you lost after the 60 days if we can prove that we could have stopped someone from taking the money if you had told us in time.
If a good reason (such as a long trip or a hospital stay) kept you from telling us, we will extend the time period.
(2) Additional Limit on liability for Mastercard ® debit card. You will not be liable for any unauthorized transactions using your Mastercard debit card if: (i) you can demonstrate that you have exercised reasonable care in safeguarding your card from the risk of loss or theft, and (ii) upon becoming aware of a loss or theft, you promptly report the loss or theft to us. (Mastercard is a registered trademark of Mastercard International Incorporated).
(b) Contact in Event of Unauthorized Transfer – If you believe your card and/or code has been lost or stolen, call or write us at the telephone number or address listed in this disclosure. You should also call the number or write to the address listed in this disclosure if you believe a transfer has been made using the information from your check without your permission.
Error Resolution Notice
In case of errors or questions about your electronic transfers, call or write us at the telephone number or address listed in this disclosure, as soon as you can, if you think your statement or receipt is wrong or if you need more information about a transfer listed on the statement or receipt. We must hear from you no later than 60 days after we sent the FIRST statement on which the problem or error appeared.
If you have inquiries regarding your account, please contact us at:
Cattle Bank & Trust
Customer Service
104 South 5th
Seward, NE 68434
BUSINESS DAYS: Monday, Tuesday, Wednesday, Thursday, Friday
Holidays are not included.
PHONE: (402)643-3636
Agreement – These terms govern the operation of this account unless varied or supplemented in writing. Unless it would be inconsistent to do so, words and phrases used in this document should be construed so that the singular includes the plural and the plural includes the singular. As used in this form, the words “we,” “our,” or “us” mean the financial institution and the words “you” or “your” mean the account holder(s). “Party” means a person who, by the terms of an account, has a present right, subject to request, to payment from the account other than as a beneficiary or agent. This account may not be transferred or assigned without our written consent.
Much of our relationship with our deposit customers is regulated by state and federal law, especially the law relating to negotiable instruments, the law regulating the methods of transferring property upon death and the rights of surviving spouses and dependents, the law pertaining to estate and other succession taxes, the law regarding electronic funds transfer, and the law regarding the availability of deposited funds. This body of law is too large and complex to be reproduced here.
The purpose of this form is to:
We may permit some variations from this standard agreement, but any such variations must be agreed to in writing either on our signature card for the account or in some other written form.
Liability – You agree, for yourself (and the person or entity you represent if you sign as a representative of another) to the terms of this account and the schedule of charges that may be imposed. You authorize us to deduct these charges as accrued directly from the account balance. You also agree to pay additional reasonable charges we may impose for services you request which are not contemplated by this agreement. You also agree to be severally liable for any account deficit resulting from charges or overdrafts, whether caused by you or another authorized to withdraw from this account, and the costs we incur to collect the deficit including, to the extent permitted by law, our reasonable attorneys’ fees.
Deposits – Any items, other than cash, accepted for deposit (including items drawn “on us”) will be given provisional credit only until collection is final (and actual credit for deposits of, or payable in, foreign currency will be at the exchange rate in effect on final collection in U.S. dollars). Unless otherwise disclosed, interest on non-consumer accounts will be paid only on collected funds, subject to minimum balance or other limitations, if any. We are not responsible for transactions initiated by mail or outside depository until we actually record them. All transactions received after our “daily cut-off time” on a business day we are open, or received on a day in which we are not open for business, will be treated and recorded as if initiated on the next following business day that we are open.
Withdrawals – Unless otherwise clearly indicated on the account records, any one of you who signs the account agreement/signature card including authorized signers, may withdraw or transfer all or any part of the account balance at any time on forms approved by us. Each of you (until we receive written notice to the contrary) authorizes each other person signing the account agreement/signature card to endorse any item payable to you or your order for deposit to this account and any other transaction with us. We may charge against your account a check, even though payment was made before the date of the check, unless you have given us written notice of the postdating. The fact that we may honor withdrawal requests which overdraw the finally collected account balance does not obligate us to do so, unless required by law. Withdrawals will first be made from collected funds, and we may, unless prohibited by law or our written policy, refuse any withdrawal request against uncollected funds, even if our general practice is to the contrary. We reserve the right to refuse any withdrawal or transfer request which is attempted by any method not specifically permitted, which is for an amount less than any minimum withdrawal requirement, or which exceeds any frequency limitation. Even if we honor a nonconforming request, repeated abuse of the stated limitations (if any) may eventually force us to close this account. We will use the date a transaction is completed by us (as opposed to the day you initiate it) to apply the frequency limitations. On interest-bearing accounts other than time deposits, we reserve the right to require at least seven days’ written notice before any withdrawal or transfer. Withdrawals from a time deposit prior to maturity or prior to the expiration of any notice period may be restricted and may be subject to penalty. See your notice of penalties for early withdrawal.
Ach and Wire Transfers – This agreement is subject to Article 4A of the Uniform Commercial Code in the state in which you have your account with us. If you originate a fund transfer for which Fedwire is used, and you identify by name and number a beneficiary financial institution, an intermediary financial institution or a beneficiary, we and every receiving or beneficiary financial institution may rely on the identifying number to make payment. We may rely on the number even if it identifies a financial institution, person or account other than the one named. You agree to be bound by automated clearinghouse association rules. These rules provide, among other things, that payments made to you or originated by you, are provisional until final settlement is made through a Federal Reserve Bank or payment is otherwise made as provided in Article 4A-403(a) of the Uniform Commercial Code. If we do not receive such payment, we are entitled to a refund from you in the amount credited to your account and the party originating such payment will not be considered to have paid the amount so credited. If we receive a credit to an account you have with us by wire or ACH, we are not required to give you any notice of the payment order or credit.
Ownership of Account – You intend these rules to apply to this account depending on the form of ownership and beneficiary designation, if any. We make no representations as to the appropriateness or effect of the ownership and beneficiary designations, except as they determine to whom we pay the account funds. Single Party Account – Such an account is owned by one party. Multiple
Party Account – Parties own the account in proportion to their net contributions unless there is clear and convincing evidence of a different intent. Corporate, Partnership, and other Organizational Accounts – We reserve the right to require the governing body of the legal entity to give us a separate authorization telling us who is authorized to act on its behalf. We will honor such an authorization until we actually receive written notice of a change from the governing body.
Rights at Death – Single Party Account – At death of party, ownership passes as part of party’s estate. Multiple Party Account with Right of Survivorship – At death of party, ownership passes to surviving parties. If two or more parties survive and one is the surviving spouse of the deceased party, the amount to which the deceased party, immediately before death, was beneficially entitled by law belongs to the surviving spouse. If two or more parties survive and none is the spouse of the decedent, the amount to which the deceased party, immediately before death, was beneficially entitled by law belongs to the surviving parties in equal shares. Multiple Party Account without Right of Survivorship – At death of party, deceased party’s ownership passes as part of deceased party’s estate. Single Party Account with POD (Pay-on-Death) Designation – At death of party, ownership passes to POD beneficiaries and is not part of party’’ estate. Multiple Party Accounts with Right of Survivorship and POD (Pay-on-Death) Designation – At death of last surviving party, ownership passes to POD beneficiaries and is not part of last surviving party’s estate.
Stop-Payments – A stop-payment order must be given in the manner required by law and must be received in time to give us a reasonable opportunity to act on it before our stop-payment cut-off time. Our stop-payment cut-off time is one hour after the opening of the next banking day after the banking day on which we receive the item. Additional limitations on our obligation to stop-payment are provided by law. A stop-payment order must precisely identify the number, date and amount of the item, and the payee. We will honor a stop-payment request by the person who signed the particular item, and, by any other person, even though such other person did not sign the item, if such other person has an equal or greater right to withdraw from this account than the person who signed the item in question. A release of the stop-payment request may be made only by the person who initiated the stop-payment.
Amendments and Termination – We may change any term of this agreement. Rules governing changes in interest rates have been provided separately. For other changes we will give you reasonable notice in writing or by any other method permitted by law. We may also close this account at any time upon reasonable notice to you and tender of the account balance personally or by mail. Notice from us to any one of you is notice to all of you.
Statements – You must examine your statement of account with “reasonable promptness.” If you discover (or reasonably should have discovered) any unauthorized payments or alterations, you must promptly notify us of the relevant facts. If you fail to do either of these duties, you will have to either share the loss with us, or bear the loss entirely yourself (depending on whether we exercised ordinary care and, if not, whether we substantially contributed to the loss). The loss could be not only with respect to items on the statement but other items forged or altered by the same wrongdoer. You agree that the time you have to examine your statement and report to us will depend on the circumstances, but that such time will not, in any circumstance, exceed a total of 30 days from when the statement is first made available to you.
You further agree that if you fail to report any unauthorized signatures, alterations, forgeries or any other errors in your account within 60 days of when we made the statement available, you cannot assert a claim against us on any items in that statement, and the loss will be entirely yours. This 60 day limitation is without regard to whether we exercised ordinary care. The limitation in this paragraph is in addition to that contained in the first paragraph of this section.
Direct Deposits – If, in connection with a direct deposit plan, we deposit any amount in this account which should have been returned to the Federal Government for any reason, you authorize us to deduct the amount of our liability to the Federal Government from this account or from any other account you have with us, without prior notice and at any time, except as prohibited by law. We may also use any other legal remedy to recover the amount of our liability.
Set-Off – You each agree that we may (without prior notice and when permitted by law) set off the funds in this account against any due and payable debt owed to us now or in the future, by any of your having the right of withdrawal, to the extent of such persons’ or legal entity’s right to withdraw. If the debt arises from a note, “any due and payable debt” includes the total amount of which we are entitled to demand payment under the terms of the note at the time we set off, including any balance the due date for which we properly accelerate under the note. This right of set-off does not apply to this account if: (a) it is an Individual Retirement Account or other tax-deferred retirement account, or (b) the debt is created by a consumer credit transaction under a credit card plan, or (c) the debtor’s right of withdrawal arises only in a representative capacity. We will not be liable for the dishonor of any check when the dishonor occurs because we set off a debt against this account. You agree to hold us harmless from any claim arising as a result of our exercise of our right of set-off.
Agency (Power Of Attorney) Designation – Agents may make account transactions on behalf of the parties, but have no ownership or rights at death unless named as Pay-on-Death beneficiaries.
Restrictive Legends – We are not required to honor any restrictive legend on checks you write unless we have agreed to the restriction in writing signed by one of our officers. Examples of restrictive legends are “must be presented within 90 days” or “not valid for more than $1,000.”
The account owner and custodian make the following agreement:
This agreement relates to a Health Savings Account as defined in IRS Code Section 223 as detailed in IRS Publication 969.
Article I
The Custodian will accept only cash (or check) contributions except in the case of a rollover contribution.
1. The custodian will accept additional cash contributions for the tax year made by the account owner or on behalf of the account owner (by an employer, family member or any other person).
2. Qualified HSA distributions from a health flexible spending arrangement or health reimbursement arrangement must be completed in a trustee-to-trustee transfer and are not subject to the maximum annual contribution limit set forth in Article II.
3. Qualified HSA funding distributions from an individual retirement account must be completed in a trustee-to-trustee transfer and are subject to the maximum annual contribution limit set forth in Article II.
Article II
1. For calendar year 2025, the maximum annual contribution limit for an account owner with single coverage is $4,300. For calendar year 2025, the maximum annual contribution limit for an account owner with family coverage is $8,550. These limits are subject to cost-of-living adjustments after 2025. Your eligibility to contribute to an HSA is determined by the effective date of your HDHP coverage. If you do not have HDHP coverage for the entire year, you will not be able to make the maximum contribution. All contributions (including catch-up contributions) must be pro-rated. Your annual contribution depends on the number of months of HDHP coverage you have during the year (count only the months where you have HDHP coverage on the first day of the month). For years after 2006 a special rule allows you to contribute the maximum amount for the year as long as you have coverage for December. However, if you fail to remain covered for the following year, the extra contribution above the pro rated amount is included in income and subject to an additional 10 percent tax.
2. Contributions for any tax year may be made at any time before the deadline for filing the account owner’s federal income tax return for that year (without extensions).
3. Rollover contributions from an HSA or an Archer Medical Savings Account (Archer MSA) need not be in cash and are not subject to the maximum annual contribution limit set forth in Article II.
4. Contributions to Archer MSAs or other HSAs count toward the maximum annual contribution limit to this HSA.
5. An additional $1,000 catch-up contribution may be made for an account owner who is at least age 55 or older and not enrolled in Medicare.
6. Contributions in excess of the maximum annual contribution limit are subject to an excise tax. However, the catch-up contributions are not subject to an excise tax.
Article III
It is the responsibility of the account owner to determine whether contributions to this HSA have exceeded the maximum annual contribution limit described in Article II. If contributions to this HSA exceed the maximum annual contribution limit, the account owner shall notify the custodian that there exist excess contributions to the HSA. It is the responsibility of the account owner to request the withdrawal of the excess contribution and any net income attributable to such excess contribution. The custodian may charge a fee of $50.00 for the correction and distribution of excess contributions.
Article IV
The account owner’s interest in the balance in this custodial account is non-forfeitable.
Article V
1. No part of the custodial funds in this account may be invested in life insurance contracts or in collectibles as defined in section 408(m).
2. The assets of this account may not be commingled with other property except in a common trust fund or common investment fund.
3. Neither the account owner nor the custodian will engage in any prohibited transaction with respect to this account (such as borrowing or pledging the account or engaging in any other prohibited transaction as defined in section 4975).
Article VI
1. Distributions of funds from this HSA may be made upon the direction of the account owner.
2. Distributions from this HSA that are used exclusively to pay or reimburse qualified medical expenses of the account owner, his or her spouse, or dependents are tax-free. However, distributions that are not used for qualified medical expenses are included in the account owner’s gross income and are subject to an additional 10 percent tax on that amount. The additional 10 percent tax does not apply if the distribution is made after the account owner’s death, disability, or reaching age 65.
3. The custodian is not required to determine whether the distribution is for the payment or reimbursement of qualified medical expenses. Only the account owner is responsible for substantiating that the distribution is for qualified medical expenses and must maintain records sufficient to show, if required, that the distribution is tax-free.
Article VII
If the account owner dies before the entire interest in the account is distributed, the entire account will be disposed of as follows:
1. If the beneficiary is the account owner’s spouse, the HSA will become the spouse’s HSA as of the date of death.
2. If the beneficiary is not the account owner’s spouse, the HSA will cease to be an HSA as of the date of death. If the beneficiary is the account owner’s estate, the fair market value of the account as of the date of death is taxable on the account owner’s final return. For other beneficiaries, the fair market value of the account is taxable to that person in the tax year that includes such date.
Article VIII
1. The account owner agrees to provide the custodian with information necessary for the custodian to prepare any report or return required by the IRS.
2. The custodian agrees to prepare and submit any report or return as prescribed by the IRS.
Article IX
Notwithstanding any other article that may be added or incorporated in this agreement, the provisions of Articles I through VIII and this sentence are controlling. Any additional article in this agreement that is inconsistent with section 223 or IRS published guidance will be void.
Article X
This agreement will be amended from time to time to comply with the provisions of the Code or IRS published guidance. Other amendments may be made with the consent of the persons whose signatures appear above.
Article XI
Definitions
IMPORTANT NOTE:Cattle Bank & Trust Health Savings Account Disclosure Statement is provided as a service to persons who are considering opening a Health Savings Account (HSA). This Disclosure Statement is furnished to individuals with the understanding that qualifications for opening and maintaining an HSA are complex, the Disclosure Statement is believed to be accurate as of January 31, 2006, future changes in the law or interpretations of the law may occur that could make the information in this Disclosure Statement incorrect or incomplete, and that Cattle Bank & Trust is under no obligation to update the information in this Disclosure Statement. Furthermore, this Disclosure Statement is furnished with the understanding that an individual considering whether to open an HSA is doing so only after having read the Disclosure Statement and, to the extent necessary, after having consulted with the individual’s own accountant or tax advisor. We are not responsible for providing tax or legal advice and this disclosure is neither. This Disclosure Statement only describes information relating to the tax treatment of HSAs under the Federal Internal Revenue Code (“Code”), and does not address any other information or laws that may apply to HSAs (including state laws or laws of any other taxing jurisdiction).
What are the rules regarding rollovers and transfers of HSAs? You may withdraw any portion or all of the funds from one HSA or Archer MSA and roll them to an HSA account with another custodian or trustee. However, you are required to roll the funds into a new HSA within 60 calendar days of your receipt of the funds. Another rule provides that you are only allowed to make one HSA rollover in a 12-month period. The 12-month period begins on the date you receive the distribution, not on the date you roll it to another HSA. In addition, you may transfer your Archer MSA or HSA funds directly from one HSA custodian or trustee to another without ever having direct control or custody of the funds. Rollover and transfer contributions are not deductible and do not count against the annual contribution limits discussed earlier in this Disclosure Statement.
What information must be filed with the IRS? As custodian, we will send each year to the IRS and to you a form, showing a valuation of your HSA as of December 31 of the prior year, and a report of the contributions to your HSA for the prior year. Unless we receives either a certification from your employer that contributions were made by the employer, or a notification from you that a contribution is a rollover contribution, all contributions will be reported as tax-deductible contributions made by you. Distributions will be reported by us on Form 1099-SA. Unless you provide written notice to the contrary, we will conclusively assume that any distribution, whether by check, debit card, or otherwise, is a “normal distribution” for purposes of tax reporting. Normal distributions include distributions for qualified medical expenses, and expressly exclude the following: return of excess contributions, distributions following your disability, distributions following your death, and prohibited transactions. If a distribution falls within one of these exceptions, you must provide written notification to us within seven (7) days following such distribution.
Other Legal Requirements: In addition to the legal requirements discussed elsewhere in this Disclosure Statement, your HSA is subject to the following rules:
Note that any HSA you establish with us. Is subject to the terms set forth in the Savings Account Custodial Agreement, the HSA Deposit Account Terms and Conditions, the Enrollment Form and the Additional Information related thereto, and the MasterCard® HSA Debit Card Cardholder Agreement.
The following fees may be assessed against your account.