Health Savings Account (HSA)

Save pre-tax dollars for qualified medical expenses through the State of New Mexico's HSA program, available with the Silver PPO high deductible health plan

Enrollment Form Eligibility Requirements Contribution Information

A Health Savings Account (HSA) allows you to set aside pre-tax dollars to pay for qualified medical expenses. To be eligible, you must be enrolled in the Silver PPO high deductible health plan (HDHP). HSA benefits for the State of New Mexico are administered by EASI Gov, Inc.

If you have any questions, contact us by phone at (505) 244-6000 or email at SONM@easitpa.com.

HSA Enrollment Form

Complete the HSA enrollment form to open your Health Savings Account with EASI Gov, Inc.

Eligibility Requirements

When opening an HSA with EASI Gov, Inc. I understand and agree to the following:

  • I am at least 18 years old and cannot be claimed as a dependent on someone else's tax return.
  • I have elected coverage under the Silver PPO high deductible health plan (HDHP).
  • I am not enrolled in Medicare.
  • I do not have any other non-qualified health coverage.
  • I do not have a flexible spending account (FSA) to pay for medical expenses incurred before my medical plan deductible is met, unless it is limited to pay for dental and vision expenses only.
  • My spouse, if applicable, does not have a flexible spending account (FSA) to pay for medical expenses before their medical plan deductible is met, unless it is limited to pay for dental and vision expenses only.

As a follow-up to this application, you will need to login to the HSA website to accept your terms and conditions.

Contribution Information

Note – The HSA has a maximum annual contribution limit that is determined by your health insurance coverage (self-only/family). Your employer may choose to contribute to your HSA, which will count towards your maximum contribution allowed. Your health plan eligibility determines the effective date of your HSA. If you are covered on December 1, you're considered eligible for the entire year and not required to pro-rate your contributions. If you cease to be an eligible individual during the next calendar year, any contributions over the prorated amount may be an excess contribution. You are solely responsible for determining whether contributions to your HSA exceed the maximum annual contribution limitation. You are also responsible for notifying the custodian of any excess contribution and requesting a withdrawal of the excess contribution together with any net income attributable to the excess contribution. For additional information regarding eligibility and contribution limits please go to: www.irs.gov.