Welcome to Firefighters & Company Federal Credit Union online HSA enrollment

This application is to establish a new HSA with Firefighters & Company FCU.

If you already have an existing HSA with Firefighters & Company FCU, you do not need to fill out this application. Please contact Firefighters & Company Federal Credit Union at 937-228-1614 if you need assistance with your existing HSA.

Our lobby is available to open your HSA if that is more convenient for you. Please call us if you would like to schedule an appointment.
This is a secure site. We are excited to have you as a member and to have your HSA with us. Once you fill out the application, you will receive the HSA forms via email to sign electronically within a few days. If you have any questions about filling out the forms, please contact Firefighters & Company Federal Credit Union at 937-228-1614 or staff@ffcocu.org.
Once your application is processed, you will receive your account number to give to payroll, disclosures, info for online services, and credit union information via email. We will also follow up with a phone call in the following weeks to answer any questions and make sure you have everything you need for your HSA account with Firefighters & Company Federal Credit Union.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person when opening a new account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.
By submitting this application, I (we) agree that acceptance of this application is conditional upon a credit check and other identity verification.
Step 1: Account Holder Information
All fields are required except where indicated.
HSA Information
Select Yes or No
Please enter a valid FFCOCU Account Number
Select Yes or No
Select an HSA plan type
Personal Information (Account Holder)
Please enter the first name of the account holder
Please enter the middle name of the account holder
Please enter the last name of the account holder
Please enter the street address of the account holder
Please enter the street address of the account holder
Please enter the mailing address city of the account holder
Please select the mailing address state of the account holder
Please enter the 5-digit mailing address zip of the account holder. (ex: 45227)
Please use the format 999-99-9999
Invalid Date
Invalid Phone
Invalid Phone
Invalid Email
Please enter the name of your employer
Invalid PIN. Must be 4 digits.
Must be mm/dd/yyyy
Must be mm/dd/yyyy
Select Yes or No
Please fix the issues above and try again.
Need Help?
Call us at 937-228-1614
Monday-Friday 10am-6pm, excluding major U.S. holidays