GENERAL DOCUMENTS
LEGAL AND POLICY
HSA DOCUMENTS
Beneficiary Designation
Change of Personal Information
Closure Request
Contribution Form
Distribution Excess HSA Contributions
Electronic Transfer of Funds
HSA Letter of Medical Necessity
Instructions Upon Death
MotivHSA Employee Contribution Election
Employer HSA Contribution Upload
HSA Partial Transfer Out Request Form
PROVIDER DOCUMENTS
Our payor policy is currently under construction. If you are a provider and have questions, please contact ProviderServices@motivhealth.com
MotivHealth Insurance Company
844-234-4472 | MEMBERS MEDICAL
South Jordan, UT 84095
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