NOTE: HSA legislation was changed in December 2006 (HR6111). Key changes that impact contributions include:
a) annual contribution limits are now based on actual IRS limits, not your plan deductible (in most cases, this means you will be able to contribute more),
b) your annual HSA contribution limit does not have to be pro-rated based upon months of HSA eligibility (note qualifiers below), and
c) your catch-up contribution does not have to be pro-rated based upon months of HSA eligibility.
It is ultimately your responsibility to ensure that 1) You are eligible to contribute to a HSA; and 2) You do not contribute more than your allowable limit. |
Contribution Estimator |
|
Instructions: Enter
information in the boxes below. The estimator will then
automatically calculate your maximum allowable contribution and estimated tax
savings. The right hand column provides line-by-line instructions
|
| Single or Family Coverage |
|
Select Single or Family HDHP
coverage (Family is defined as > 1 person covered).
|
|
What is
the first full month when you will be able to make HSA contributions
|
|
This
is most often the same as the start of the HDHP with one exception: If you
are participating in a full healthcare FSA in 2006, have unspent funds as of
12/31/2006 and your employer supports the 2 1/2 month extension of the full
healthcare FSA (the "grace period"), you are not allowed to make
HSA contributions until April.
|
|
Allowable Base Contribution:
|
|
This is the baseline
contribution allowed into your HSA. However, there are two other areas to
consider.
|
|
Catch-Up Contributions:
|
|
Date of Birth (mm/dd/yyyy).
Requires a four-digit year.
|
|
Enter
your date of birth (mm/dd/yyyy). HSA rules allow a HSA owner who is at least
55 years old (and not enrolled in Medicare) to make additional
"catch-up" contributions into their HSA. The allowable contribution
for an individual who was 55 by 12/31/07 is $800.
|
|
Allowable Catch-up
Contribution
|
|
This is the catchup contribution
you can add to your base contribution.
|
|
Maximum Annual Contribution
Limit:
|
|
Maximum annual contribution for
2007 from all sources.
|
|
Your Employer Contributions
(if applicable):
|
|
Enter
the amount that your employer is going to contribute to your HSA during 2007.
If you employer is not making any contributions into your HSA, leave this box
blank. Note: If you sign up for an HSA mid-year, your employer
may prorate contributions.
|
|
Your Maximum Annual
Contribution Limit:
|
|
This
is the maximum contribution that you are permitted to make into your HSA
during 2007, either through payroll contributions or additional deposits. You
may contribute less than this amount, but exceeding this amount can result in
IRS penalties.
|
Tax Savings Estimator for
2007
|
|
Will you make the maximum
contribution from above?
|
|
If you say yes, the maximum
contribution will automatically carry over to the Tax Savings Estimator.
|
|
If no, how much will you
contribute for 2006?
|
|
The amount you enter must be
less than the Maximum Annual Contribution Limit.
|
|
Enter your estimated federal
tax income rate
|
|
Your marginal federal income tax
rate (25% is used as a default)
|
|
Enter your estimated state
income tax rate (if applicable)
|
|
Your marginal state income tax
rate (0% is used as a default). If your state does not provide a tax
advantage to HSAs (Alabama, California, New Jersey, and Wisconsin) or does
not have an income tax, the amount will be 0.
|
|
2007
Estimated Tax Savings*
|
|
This
is the estimated amount of money you saved in 2007 taxes. (* Assumes all
payments from the HSA are used for qualified medical expenses or
distributions are not made until age 65.)
|
|
|
|
|
|
|
Please note: This worksheet is only a guide. Actual amount
may vary depending on your individual circumstances. SHPS and its
affiliates are not engaged in rendering tax advice. Federal and State
tax laws and regulations are subject to change. If tax or legal advice
is required, please seek the services of a qualified professional.
|