Benefit Services| Miami University

Health Savings Account

United Missouri Bank

Humana Access Card

Details About your HSA

HSA Employee Contribution Change Form
Change the amount deducted from you paycheck at any time.

Request reimbursement from your HSA
Log in to MyHumana, click on "Claims & Spending," "Spending Accounts," and then "Request Reimbursement."

HSA Beneficiary Designation Form

HSA Deposit Slip

HSA Eligibility Form

CREATING A DIGITAL SIGNATURE

IRS Publication 969
"Health Savings Accounts and Other Tax-Favored Health Plans"

Benefit Services
15 Roudebush Hall
(513) 529-3926
(513) 529-4223 FAX
benefits@muohio.edu