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HSA custodian

HSA Bank

Self-calc requiredLast verified 2026-05-04
Form name
Health Savings Account Excess Contribution Removal Form (PDF)
Auto-calculates NIA?
No — bring hand-calculated figure
Official page
NIA calculation note

HSA Bank's official excess-removal form (PDF) requires the holder to fill in 'Earnings on excess: $___.' Form text instructs use of the §1.408-11 calculation method.

Known quirks

  1. 1Form contains a dedicated 'Earnings on excess: $___' field that the holder must fill in. Form text directs use of '§1.408-11' calculation method (the IRA NIA reg, transposed onto the HSA form).
  2. 2Form offers an alternate option to 'Apply my excess contribution as my current year's contribution' — flagged on the form itself as potentially triggering 6% excise tax.
  3. 3Default refund method is by check unless an external bank account is linked to the HSA.
  4. 4HSA NIA is taxable in the year RECEIVED (per §223(f)(3)) — different from IRA NIA, which is taxable in the contribution year. Plan accordingly.
  5. 5Form does not provide Form 8889 guidance; refer to IRS Pub 969 for tax-related questions.

Submission method

Online upload via account.hsabank.com Secure Document Upload, email to [email protected], or mail to 909 N 8th Street, Suite 200, Sheboygan, WI 53081-4056.

Process at HSA Bank

  1. Confirm the contribution is in fact excess (limit lookup, MAGI check).
  2. Compute NIA — required; custodian will not calculate.
  3. Submit the Health Savings Account Excess Contribution Removal Form.
  4. Allow processing time per the custodian's stated SLA (typically 3–10 business days).
  5. Receive Form 1099-R (IRA) or 1099-SA (HSA) the following January with the applicable distribution code (8 / P for IRA current vs prior-year correction).
  6. Report the earnings (NIA) as taxable income — in the year of distribution per IRC §223(f)(3).

Logo & branding note

HSA Bank's wordmark and logo are not displayed on this page. The initials mark above is a neutral placeholder; using the custodian's actual mark requires permission.

Also relevant

Informational, not tax advice. Consult a CPA or Enrolled Agent before acting on a corrective distribution.