General Forms
FirstHSA Health Savings Account Application (Word, 130k)
Business Associate Agreement (PDF, 53k)
Commission Scale (PDF, 308k)
CPA Lawyer Attestation Form (PDF, 92k)
Small Group Employer Request for Coverage PH-2000 (PDF, 23k)
Large Group Request for Coverage PH-3000 (PDF, 36k)
Health Advocate Kit Brochure (PDF, 523k)
HSA (PDF, 67k)
PH Employee Enrollment and Change Form (Word, 125k)
PerfectHealth Advisors: Benefits at-a-Glance(PDF, 212k)
PerfectHealth HSA Plan Contribution Limits(PDF, 307k)
PerfectHealth Plan Strategies: Benefits at-a-Glance(PDF, 216k)
Producer Commission Agreement PerfectHealth (PDF, 21k)
Producer Information (PDF, 22k)
Waiver of Coverage (PDF, 90k)
W9 Form (PDF, 32k)

Information
What forms are needed to submit an HSA case?
Employer Application
Employee Application
Waiver Forms
Prior carrier bill and proof of 12 months prior coverage
HSA administrator applications
Check payable to HSA Administrator for set up fee's and initial deposit
Check payable to PerfectHealth equal to first months premium
Signed copy of final proposal
Current signed tax evidence
Verification of dependents over upper age limit (handicap – F/T student)