Create A Custom CorporateHCSA Proposal. Fill in the form below and click Create Proposal.
Company Information:


HSA Admin Fee:


Employee Information:
Create the Job Classifications for your company below, and enter the annual HCSA limits for Single Employees and Employees with Families for each Job Classification. You can enter any amount.
Job Description HCSA Limits # of Employees
Single: $/yr

Family: $/yr


Single: $/yr

Family: $/yr


Single: $/yr

Family: $/yr


Typical Usage
% HSA Used 25% 40% 65% 100%
HSA $ Spent - Single $0 $0 $0 $0
HSA $ Spent - Family $0 $0 $0 $0
HSA Admin Fee $0 $0 $0 $0
Enrollment Fee (one time only) $300 $300 $300 $300
Total Cost to You $0 $0 $0 $0