Cornerstone Bank Introduces
Health Savings Accounts!

Thank you for your interest in Cornerstone Community Bank’s Health Savings Account (HSA). HSAs can provide significant tax benefits to eligible individuals. Not only can HSAs provide tax benefits related to paying qualified medical expenses, they may also provide benefits similar to many tax-favored retirement plans.

In choosing Cornerstone Community Bank as your HSA custodian, you can rest assured your FDIC-insured account is safe, and your investment can grow with our competitive interest rates and low fee structure. Cornerstone is a full-service bank with a friendly, helpful staff. And, we offer free 24-hour account access to your HSA through our Telephone and Online Banking systems.

GETTING STARTED

Once you purchase a qualified High Deductible Health Plan (HDHP), simply print the HSA Application found below. Complete the applicable forms legibly and completely. Send or bring the forms to Cornerstone Community Bank with your initial contribution, a photocopy of your driver's license, a $20.00 set up fee, and $8.65 for your first order of checks. We’ll take care of the rest.

Within 14 days after we receive your application, you will receive your HSA checks and a debit/ATM card (if applicable). Monthly you will receive an account statement with images of your checks.

Our Online Banking service gives you 24 x 7 access to your account. You may sign up for Online Banking by going to www.bankwithcornerstone.com. Be sure to have your latest statement handy for required data input. We also provide anytime-access to your account through our Telephone Banking service at 1-888-750-7152.

Our friendly, knowledgeable staff is always eager to help. If you need assistance, our personal bankers can be reached at (262) 375-9150 or toll free at 1-888-750-7152.

HSA APPLICATION

To open your HSA, open the PDF file below, print the documents, and complete the applicable forms. Return completed forms to Cornerstone Community Bank, 2090 Wisconsin Ave., Grafton, WI 53024. Please include your initial contribution, a photocopy of your driver's license, a $20.00 set up fee, and $8.65 for your first order of checks.

HSA Application

DO YOUR HOMEWORK!

The above download includes an HSA Eligibility and Information Form that must be submitted with your application. This checklist will aid you in determining your HSA eligibility. In addition, you should consult your insurance provider to confirm that your policy is HSA qualified, since there are some very specific IRS requirements that must be met in order for a policy to be eligible.

The following links may be of help to determine your eligibility or to answer other HSA-related questions:

HSA Insider
HSA Finder
U.S. Treasury
Internal Revenue Service

DO YOU NEED A HIGH-DEDUCTIBLE HEALTH PLAN?

Cornerstone is pleased to recommend WPS Health Insurance of Madison, WI, and their authorized agent, A.N. Ansay & Associates, Pt. Washington, WI for your insurance needs. WPS and Ansay are Cornerstone preferred vendors offering a variety of insurance options, including high-deductible plans. We invite you to visit them by clicking on the links below:

A.N. Ansay and Associates

OTHER OPTIONAL HSA FORMS

(For Online Contributions from another bank account.)
HSA Contribution/Investment Form
HSA Designation of Beneficiary Form
HSA Eligibility & Information Form
HSA Rollover Certification Form
HSA Transfer Request Form
HSA Withdrawal Statement Form

2007

Self Only - $2,850
Family - $5,650

Over 55 Catch-up Contribution - $800

2008

Self Only - $2,900
Family - $5,800

Over 55 Catch-up Contribution - $900

HSA FEES

Set-up: $20 (waived for HSA/MSA rollovers)
Maintenance: Free the first year, then $2.00/month if balance falls below $500.00
Checks: $8.65 (no transaction fee)
Debit Card: Free
Tiered Interest Rate:

0-$2,500 Balance 1.00%

$2,500-$10,000 Balance 1.25%

$10,000-$20,000 Balance 1.50%

>$20,000 Balance 1.75%

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