Open a Health Savings Account (HSA) by Mail

Thank you for your interest in opening a Health Savings Account (HSA) at Elevations Credit Union. Please complete the following steps in order to ensure your HSA is established accurately and efficiently:

Non-Members: Please complete the New Membership and Services Application [PDF] to open a savings account with $25 or more (establishes your membership), and an HSA. Then proceed to step 2 below, leaving your account number blank.

Members:
1. Complete the New Membership and Services Application [PDF] including the sections on HSAs (You may skip the sections on Account Requests, Account Services, Joint Information and Visa Credit Card Agreement).

2. Complete the CUNA Mutual Group HSA Application [PDF].
  • Print your personal information.
  • Fill in your current Elevations Credit Union account number. We will assign a new account number to your Health Savings Account as it is opened.
  • Where the form says "I instruct the credit union to invest this HSA in the following investment," indicate your choice from below:
    • HSA Checking
    • HSA Certificate (indicate 3, 6, 12, 18, 24, 36, 48 or 60-month term)
    • HSA Checking and HSA Certificate of ____ months.
  • List your beneficiary information. List your secondary beneficiaries, if applicable.
  • If you have designated your spouse as less than 50% primary beneficiary, your spouse will need to sign for consent.
  • Sign and date under Account Owner's Signature. Retain the Agreement and Disclosure information for your records.
3. To arrange a direct transfer or rollover from another HSA or Archer Medical Savings Account, please fill out the appropriate forms: Direct Transfer Form [PDF], Rollover Form [PDF].

Bring your completed applications to any Elevations branch location or mail them to the following address:

Attn: Operations Administration
Elevations Credit Union
PO Box 9004
Boulder, CO 80301

We would be happy to assist you in filling out the applications to establish a new Health Savings Account. Please feel free to call 303.443.4672 or 800.429.7626, or stop by any branch location.