HSA Instructions

​4 Simple Steps To Establish a Health Savings Account Attorney-In-Fact for your Bankers Trust HSA

Step 1: Choose your HSA Attorney-In-Fact
An HSA Attorney-In-Fact (AIF) can exercise your rights with respect to your HSA. The agent designated as attorney-in-fact must be an adult covered under the high deductible health plan. Furthermore, the designation of attorney-in-fact is applicable only to the funds held in your Bankers Trust HSA.

Step 2: Print and Complete HSA Attorney-In-Fact form and Notary form from our website
Complete all sections of the HSA Attorney-In-Fact form. Include a password and password clue for your AIF. The password is imperative for the Bank to identify your AIF. Failing to include the password and clue will impair our ability to adequately identify and service your AIF.
Do not sign the document.

Step 3: Visit a Notary
All signatures on an HSA Attorney-In-Fact form must be witnessed by a Notary. Complete the HSA AIF form by signing the document before a Notary. Ask the Notary to complete the Notary form. (For your convenience you can complete the signature at any Bankers Trust Branch)

Step 4: Return the Forms to Bankers Trust Company
For your convenience you can drop the documents off at any one of our Bankers Trust branch locations, or you can mail your documents to:
Bankers Trust
Attn: HSA Administration
PO BOX 897
Des Moines, IA 50304-9987

We will update your account information within seven business days of receiving the completed paperwork.

If you have questions or would like assistance completing this form, please contact a Bankers Trust Customer Service Representative at 1-800-362-1688.