Sample Compensation Statements

$2 Total Compensation Statement With Health Savings Accounts

Provides information about health savings accounts and wellness programs. Click an image to download a PDF containing 2 sample statements.

NOTE: Includes overview of benefits and highlights wellness programs, HSA and contributions to an employee wellness account. If you do not offer a wellness account, when you are ready to run your preview and upload your populated spreadsheet, choose the option that has no wellness account. Statements with or without wellness accounts use the same spreadsheet. Companies that don't offer wellness accounts should leave that column blank on ths spreadsheet.

HSA Statement - Blues

Theme:
Blues

HSA Statement - Metro

Theme:
Metro

HSA Statement - Seasons

Theme:
Seasons

HSA Statement - Sarafina

Theme:
Sarafina