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123456789
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demouser
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[email protected]
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MM/DD/YYYY - Online
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Healthcare Accounts Administration
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Reimburse Myself
Send Payment
Contribute to HSA
View Investments
Manage My Expenses
Accounts
HEALTH SAVINGS ACCOUNT
AVAILABLE
Cash Account
$1,295.50 Health Savings Account Cash Account
$1,295.50
Investment Account
$0.00 Health Savings Account Investment Account
$0.00
01/01/YYYY - 12/31/YYYY
AVAILABLE
Limited Purpose FSA
Available balance $2,700.00. Plan year MM/DD/YYYY - MM/DD/YYYY
Final Filing Date: MM/DD/YYYY
Final Service Date: MM/DD/YYYY
$2,700.00
Dependent Care FSA
Available balance $1,250.01. Plan year MM/DD/YYYY - MM/DD/YYYY
Final Filing Date: MM/DD/YYYY
Final Service Date: MM/DD/YYYY
$1,250.01
Transit Acct
Available balance $780.00. Plan year MM/DD/YYYY - MM/DD/YYYY
Final Filing Date: MM/DD/YYYY
Final Service Date: MM/DD/YYYY
$780.00
Parking
Available balance $773.50. Plan year MM/DD/YYYY - MM/DD/YYYY
Final Filing Date: MM/DD/YYYY
Final Service Date: MM/DD/YYYY
$773.50
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Recent Transactions
Recent Transactions
Date
Expense
Recipient/Patient
Merchant/Provider
Submitted Amount
Status
Pay
MM/DD/20XX
Date MM/DD/20XX Expense Dental Merchant/Provider Johnson Dental Clinic Submitted Amount $12.50 Status Unpaid
Dental
Demo User
Johnson Dental Clinic
$12.50
Pay
MM/DD/20XX
Date MM/DD/20XX Expense Pharmacy Merchant/Provider CVS Submitted Amount $4.50 Status Paid
Pharmacy
Demo User
CVS
$4.50
MM/DD/20XX
Date MM/DD/20XX Expense Dental Merchant/Provider Johnson Dental Clinic Submitted Amount $6.32 Status Unpaid - Ineligible
Dental
Demo User
Johnson Dental Clinic
$6.32
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HSA Contributions & Distributions
.
20XX: Contributions $1,300.00, Distributions $4.50.
*Represents your contributions and distributions included in all 'normal' transactions per IRS forms 1099SA and 5498SA for the indicated tax year. Excludes fees, interest, transfers, rollovers, and pending transactions.
HSA Contributions by Tax Year
.
20XX: Current Contributions $1,300.00, 18.6 % of $7,500.00. Maximum Contribution $5,700.00, 81.4 % of $7,500.00.
*Represents your contributions year to date compared to the maximum amount you can contribute based on IRS guidelines. *Contribution amounts do not include pending contributions or rollovers.
Election Summary. MM/DD/YYYY - MM/DD/YYYY.
Dependent Care FSA $5,000.00, 35.9 %.
Parking $3,120.00, 22.4 %.
Transit Acct $3,120.00, 22.4 %.
Limited Purpose FSA $2,700.00, 19.4 %.
Dependent Care FSA
$5,000.00
Parking
$3,120.00
Transit Acct
$3,120.00
Limited Purpose FSA
$2,700.00
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Health Account Solutions, including Health Savings Accounts, Flexible Spending Accounts, Commuter Benefits, Health Reimbursement Arrangements, and COBRA Administration offered by Voya Benefits Company, LLC (in New York, doing business as Voya BC, LLC). Custodial services provided by an approved HSA custodian as indicated in the applicable custodial agreement. For all other products, administration services provided in part by WEX Health, Inc.
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