BenefitWallet - Participant Portal

Reimburse Myself

Important Note

Electronic payments will always be coded as a regular distribution and should not be used for trustee to trustee transfers, rollovers or excess contributions.

1 Pay To
2 Verify

Payment Type

Electronic Transfer Paper Check

Bank Name

Account Number

Direct Deposit Information

Account Holder's Name

Routing Number

Confirm Routing Number

Account Number

Confirm Account Number

Recipient's Name

Address

Address 2

City

State

Postal Code

Country

Frequency

One Time Recurring

Amount

Pay On

Monthly on:

Weekly on:

Every 1st and 15th of the month

Bi-Weekly On:

Issue Date

The Issue Date is the date we begin processing your payment. Please allow 5 to 7 business days for your payment to reach your payee. It typically takes a few days more for your payee to deposit your payment. Not until then will your payment actually decrease your account balance.

End Date

No End Date

Issue Date

Transaction Memo

The maximum text is 25 characters.

Note to Payee
(Prints on check stub body)

The maximum text is 250 characters.

Upload Document
(optional)

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You will be asked to review this payment on next page before it is submitted.

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Amount

$10.00

Frequency

One Time

Type of Payment

Paper Check

Issue Date

01/23/2017

Pay To

Pat Smith

Address

Pat Smith
110 Jared Dr,
Test City,
New Jersey 11111,
United States

Transaction Memo

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Note to Payee

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Payer Address

Current Resident Address
City,
NJ 11111,
United States

To update this address, navigate to Account Holder Services and update your address

Note: Please make sure that there are sufficient funds in the payment account, otherwise you may incur an insufficient fund fee.

Once you click Submit, you may edit or delete any individual payment from the Home screen up until 5pm Eastern Time on the issue Date for that payment. Payments become final after the issue Date. Allow 5-7 business days after issue date for your transaction to post to your account.

Your HSA Accout balance is increased or decreased when electronic deposit transfers post to your account or when payments are received and deposited by your payee.

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