b'Healthcare ElectionsHEALTH SAVINGS ACCOUNT (HSA)Deposit, Grow, Save, and Pay. Extend Your Health Care Dollars.When you elect medical coverage under the Gold Plan, a Health Savings Account (HSA) is created on your behalf. An HSA is a pre-tax benefit account used to pay for eligible medical, dental, and vision care expenses that arent covered by your insurance plan, or items that apply towards your deductible, copays, and coinsurance. Its a smart, simple way to save money while keeping you and your family healthy and protected.The money comes out of your paycheck over the course of the year. The amount you contribute to the HSA is not subject to Social Security (FICA), federal, state, or local income taxeseffectively adjusting your annual taxable salary.Deposit your health care dollars Grow your savingsPayroll Deduction: Make pre-tax payrollEarnings: Deposits to your HSA can deductions eventually be invested and could earn Deposits: Additional deposits can be madeincome-tax-free interest.with deposit forms, website and onlineCarry-over: There is no use it or lose it-transfers from your bank. unspent funds remain in your account if you Contribution limits: The IRS sets guidelineschange jobs or retire.for how much you can contribute to an HSA each year. See below for individual, family, and catch-up amounts.Save on taxes Pay for health care, now or laterContributions: Contributions to your HSAQualified medical expenses: Pay for current and are tax-deductible up to the annual limit. future medical, dental, and vision expenses for Distributions: HSA funds used to pay foryou, your spouse, and your eligible dependents. qualified medical expenses are tax-free. You can continue to use the funds in your account even if you stop participating in a high-Earnings: Interest you may earn on yourdeductible health plan (although you cannot HSA grows income tax free. contribute more to it).Payment methods: Use your debit card to pay pharmacies, doctors, clinics, and other health care providers on the spot. Or, withdraw funds to reimburse yourself for out-of-pocket expenses.Tax implications: Keep your receipts! Funds used for non-qualified expenses will be taxed as income and subject to a 20% penalty. If you are 65 and older, the 20% penalty does not apply.15'