Step 1: Enroll in a High Deductible Health Plan (HDHP) compatible with a HSA through your employer or insurance broker.
Step 2: Complete the following forms:
1) Eligibility and Information Form #3019,
2)Application Form #3500,
3)On Line Banking HSA Debit Card Application Form #3000
Two River Community Bank (TRCB) is pleased to provide you with an easy-to-use process to open a Health Savings Account (HSA).
The HSA application and supplemental form are E-Forms. They're formatted on files so that your information can be entered on your personal computer. The HSA forms are available on our website, or stop by one of our convenient locations. The forms will also be made available through your insurance broker or benefits administrator at your place of employment.
The information you enter on these forms cannot be saved to your computer or file. You must print the form after you have entered all your information. The information that you provide will be used to set up your HSA with TRCB.
Click on a form to download an Application; Eligibility Form; On Line Banking HSA Debit Card Application or call us at 1-877-706-9009.
Step 3: Opening Your HSA Account
New customer to TRCB? The Patriot Act requires that you provide two forms of identification when opening any bank account.
If you are opening an account through your local employer, complete and print the Application and Eligibility Form. A representative from TRCB will arrange with your employer to meet with you at work to set up the account and copy your two forms of identification. If you live out of the area, please call us or e-mail hsa@tworiverbank.com for specific instructions to open your account.
If you already have a HSA and want to transfer your account to TRCB, please bring the completed Application and Eligibility form with a HSA Transfer Form, or, if just starting, bring your initial contribution directly to a Two River Community Bank branch, along with two forms of identification.
Step 4: Receive Your HSA Welcome Package!
We will process your application and give you a welcome package with everything you need to begin using your Health Savings Account.
On-Line Banking Instructions
Debit Card (mailed separately)
Starter Checkbook
Your Monthly Account Statement Information
Information on End of Year Tax Forms
How to Change an Account
At Two River Community Bank, we make sure that managing your HSA information is easy, secure and convenient for you. All the forms you need to change your name, change your address, add Power of Attorney, or change your designation of beneficiary are available on line to print, complete and then mail to Two River Community Bank. We'll take it from there and update your account information promptly.
We look forward to answering your questions about Health Saving Accounts. For more information call 1-877-706-9009 or email us at HSA@tworiverbank.com.
