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Please note, the HSA Epitec offers is only available with the BCBS Simply Blue 4000 PPO for the 2024 plan year. Medical benefits must be included in your compensation package in order to enroll in medical insurance and participate in the HSA. If you would like to add medical benefits to your package, please contact the Human Resources Team via the Epitec Portal for next steps.

HSA Rollover/Transfer forms

1. Health Equity Transfer Request Form – use this form if the employee is going to transfer the funds directly from another HSA administrator into the Health Equity account.

2. Health Equity Rollover Form – use this form if the employee has already received a distribution from another HSA administrator and wants to deposit them with Health Equity.

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