|Maximum annual contribution||MAXIMUM_ANNUAL_CONTRIBUTION|
|Owner's catch-up contributions||OWNER_CATCH_UP_CONTRIBUTION|
|Spouse's catch-up contributions||SPOUSE_CATCH_UP_CONTRIBUTION|
|Total allowable HSA contribution for current year||TOTAL_ALLOWABLE_CONTRIBUTION|
|Your Estimated Tax Savings||TOTAL_TAX_SAVINGS|
|First full month your HDHP was in effect||PLAN_FIRST_FULL_MONTH|
|Type of HDHP coverage||TYPE_OF_INSURANCE_COVERAGE|
|HDHP deductible amount||INSURANCE_DEDUCTIBLE_AMOUNT|
|Marginal income tax rate**||FED_TAX_RATE|
|You will be 55 older this year||PLAN_OWNER_FIFTYFIVE|
|Your spouse will be 55 or older this year*||PLAN_SPOUSE_FIFTYFIVE|
|Change of coverage type during the year||CHANGE_IN_COVERAGE|
|First full month your new coverage was in effect||CHANGE_FIRST_FULL_MONTH|
|New HDHP deductible amount||NEW_DEDUCTION_AMOUNT|
|New type of HDHP coverage||NEW_TYPE_OF_COVERAGE|
|Loss of your HDHP during the current year||LOST_COVERAGE|
|Last full month your plan was in effect||MONTH_LOST_COVERAGE|
* By checking the box you are indicating your spouse is 55 or older this year and that they are eligible to contribute into an HSA.
** Your marginal tax rate is used to calculate your potential tax savings. We assume that all contributions receive a tax deduction at the tax rate you enter here.
In order to put money into an HSA you are required to have a High Deductible Health Plan (HDHP) in effect for either you or your family. A HDHP is simply health insurance that meets certain minimum deductible and maximum out-of-pocket expense requirements. The table below shows the limits for HSA's in 2016.
|HSA contribution limit||Single: $3,350|
|Single: No change|
|HSA catch-up contributions||$1,000||$1,000||No change, not indexed to inflation|
|HDHP mimimum deductible||Single: $1,300|
|Single: No change|
Familiy: No change
|HDHP maximum out-of-pocket**||Single: $6,550|
*Catch-up contributions can be made anytime during the year in which the participant turns 55.
**This includes deductible amount, co-payments and other non-premium payments
Please note, you are no longer eligible to make HSA contributions starting in the first month that you are eligible for and enrolled in Medicare Part A or B.
For complete details on HSAs you may wish to visit the U.S. Treasury at http://www.treasury.gov/resource-center/faqs/Taxes/Pages/Health-Savings-Accounts.aspx
|Tax Rate||Married Filing Jointly or Qualified Widow(er)||Single||Head of Household||Married Filing Separately|
|10%||$0 - $18,550||$0 - $9,275||$0 - $13,250||$0 - $9,275|
|15%||$18,550 - $75,300||$9,275 - $37,650||$13,250 - $50,400||$9,275 - $37,650|
|25%||$75,300 - $151,900||$37,650 - $91,150||$50,400 - $130,150||$37,650 - $75,950|
|28%||$151,900 - $231,450||$91,150 - $190,150||$130,150 - $210,800||$75,950 - $115,725|
|33%||$231,450 -$413,350||$190,150 - $413,350||$210,800 - $413,350||$115,725 - $206,675|
|35%||$413,350 -$466,950||$413,350 - $415,050||$413,350 - $441,000||$206,675 - $233,475|
|39.6%||Over $466,950||Over $415,050||Over $441,000||Over $233,475|
*Caution: Do not use these tax rate schedules to figure 2015 taxes. Use only to figure 2016 estimates. Source: 2015 Rev. Proc. 2015-61
Catch-up contributions are not prorated. You can deposit the entire amount into your HSA as long are 55 or older at some point during the year.
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