How to Fill Out the HealthEquity HSA Change of Personal Information Form

The HealthEquity HSA Change of Personal Information Form is a one-page PDF you use to update your name, address, date of birth, or Social Security number on your Health Savings Account. Download it from HealthEquity’s resources page or open the online version inside the member portal, attach the proof required for the specific change you’re making, and send it in by portal upload, fax, or mail.1HealthEquity. HSA Change of Personal Information Form

Where to Download the Form

The direct PDF lives at resources.healthequity.com and opens the current version of the form.1HealthEquity. HSA Change of Personal Information Form You can also sign into the HealthEquity member portal and go to the help center or forms section, which offers both the PDF and an online version you can complete and submit without printing.2HealthEquity. Account Forms If your HSA came through an employer, the benefits portal may link to the same form.

Before You Fill It Out: You May Not Need the Form

Simple contact updates don’t require this form. You can change your email, phone number, or address directly in your online account. The paper form is built for changes that affect your legal identity or tax reporting, or for an address change paired with a new debit card. If you submit the paper form for an email, phone, or address change on its own, HealthEquity requires notarized documentation to support it.1HealthEquity. HSA Change of Personal Information Form

What Documents to Attach

Every change type has its own proof requirement, printed on the form itself. Match the document to the change:1HealthEquity. HSA Change of Personal Information Form

  • Legal name change: marriage license, divorce decree, W-2, or Social Security card.
  • Address change with a new debit card requested: a utility bill, pay stub, bank statement (not your HealthEquity statement), driver’s license, or state ID showing your name at the new address.
  • Date of birth correction: driver’s license, state ID, passport, or birth certificate.
  • Social Security number correction: W-2 or Social Security card.

Sending the wrong type of document is the most common reason a submission comes back. A utility bill confirms your address but won’t support a name change; a W-2 can support a name or SSN change but doesn’t verify your date of birth.

How to Fill Out Each Section

The form has three parts: your current information, your new information, and your signature.

Current Information

Enter your details exactly as they appear on your HealthEquity account today: last name, first name, middle initial, date of birth, street address, city, state, ZIP, email, daytime phone, and either the last four digits of your SSN or your HealthEquity ID number.1HealthEquity. HSA Change of Personal Information Form This is how HealthEquity locates the account. If anything you enter here doesn’t match the file, processing stalls. Check your profile in the portal first if you aren’t sure what’s on record.

New Information

Only complete the fields you want changed. Changing your last name alone? Leave the address and phone lines blank. The field layout mirrors the top section, with a full SSN field if that’s what you’re correcting.4HealthEquity. HSA Change of Personal Information Form

New Debit Card Request

If you want a replacement HSA debit card issued with your updated name or address, initial the designated line. Your current card is permanently deactivated as soon as the request goes through, and the new card takes up to ten business days to arrive.3HealthEquity. HSA Change of Personal Information Form Skip this line if you’d rather keep using your existing card.

Signature

Print your name, sign, and date the form. Your signature authorizes HealthEquity to update the account for authentication, correspondence, and tax reporting.1HealthEquity. HSA Change of Personal Information Form You don’t need to explain why you’re making the change. A form missing either the printed name or the handwritten signature will be returned.

How to Submit

Three options, listed fastest to slowest:1HealthEquity. HSA Change of Personal Information Form

  • Member portal upload through the help center, which gives you immediate confirmation of receipt.2HealthEquity. Account Forms
  • Fax to 801-727-1005.
  • Mail to HealthEquity, PO Box 14374, Lexington, KY 40512.

Whichever route you choose, send the supporting documents in the same submission as the form.

How Long Processing Takes

HealthEquity processes the form within two to three business days of receipt. If you also requested a replacement debit card, add seven to ten business days for delivery.1HealthEquity. HSA Change of Personal Information Form After a few days, log in and check that your profile shows the new information. If nothing has changed after a week, call HSA support at 866.346.5800, which is staffed 24/7.

Why It’s Worth Getting the Update In

HealthEquity is the custodian of your HSA and files IRS Form 1099-SA for distributions and Form 5498-SA for contributions each year, using the name, SSN, and address on your account. A name or SSN that doesn’t match Social Security Administration records can trigger an IRS mismatch notice and delay your refund. An outdated address can mean you never receive your participant copy of Form 5498-SA, which HealthEquity is required to send by May 31 of the year after the contribution.5Internal Revenue Service. Instructions for Forms 1099-SA and 5498-SA If you’ve moved, updating your address before that date keeps the form from going to the wrong mailbox.