Carrier Partners


Sterling HSA
Sterling HSA Forms
Account Change Form
To change account information, 1 Page (Rev. 10/04)
Beneficiary Designation Form
Beneficiary designation to be made by all applicants, 2 Pages (Rev. 10/04)
Custodial Agreement
Applicant signature on the Individual Application acknowledges receipt and acceptance of these terms, 3 Pages
Deposit Form
For submission of individual deposits, 1 Page (Rev. 10/04)
Group Application Kit
Includes Employer How To Checklist, Employer Group Application, Census Form, 5 Pages
Individual Application
Includes Accountholder Application, Catch-Up Contribution Application, Beneficiary Designation Form., 5 Pages (Rev. 9/06)
List Bill
Use to list contribution data for subsequent transactions, 1 Page
Referral Agreement
Broker agreement., 2 Pages
Request for Debit Card
To request debit card, 1 Page (Rev. 10/04)
Request for Disbursement of Sterling HSA Funds
To request disbursements, 1 Page (Rev. 10/04)
Termination of Sterling HSA Account
To terminate an individual's account, 1 Page (Rev. 10/04)

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For additional information, please contact Claremont at 800.696.4543 or info@claremontcompanies.com

HSAs: Four Years Later and Growing Strong
By: Cora M. Tellez
July, 2008

The law creating Health Savings Accounts (HSAs) was enacted four years ago amidst growing concerns about the rising cost of healthcare and a burgeoning interest in what consumers can do to reduce cost and utilization given financial incentives to do so. In the intervening years, much has been written about HSAs, from glowing reports about adoption rates to raging criticisms about their impact on consumers who have inadequate tools to make good purchasing decisions about healthcare.

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