HSA Notice

HEALTH SAVINGS ACCOUNT NOTICE:
HSA’s can be requested during open enrollment, new hire enrollment, or special enrollment within Paylocity during the enrollment window.

*Please note: HSA’s are only offered on the Bronze Plans.

Benefits are approved no later than the last day of the enrollment window.

Paperwork must be returned within 15 days of the request for HSA.

Please return the paperwork via one of the following options:
 Must be emailed to [e-mail]
 Original Paperwork must be sent to:
      o HR Department
         PO Box 446
         Irwin, PA 15642
      o OR, sent in the black box, if applicable, to KIA North Huntingdon, Attn: HR Department
 Copy of Valid Drivers License must be included.
      o If address is different than driver’s license, the following must be included:
                       Change of Address Card; or
                       Copy of current utility bill

If paperwork is not returned within the 15 day requested time, the HSA will be cancelled and any
deducted monies will be returned the following payroll, if applicable.

If there are any additional questions on the HSA, please reach out to the HR Department directly at:
724-382-3127
[e-mail]