Firefighters & Company Federal Credit Union

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.

Firefighters & Company Federal Credit Union is open to anyone that lives, works, worships or attends school in Montgomery County, Greene County and Miami County Ohio.

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

Do you currently have an account with Firefighters & Company Federal Credit Union?

Yes

Select Yes or No

FFCOCU Account Number

Please enter a valid FFCOCU Account Number

Do you currently have an HSA?
(optional)

Yes

Are you setting up a new HSA?
(optional)

Yes

Do you need to transfer your existing HSA to Firefighters & Company Federal Credit Union from a different Financial Institution?We will contact you after you submit your HSA application and send you a Direct Transfer Form.

Yes

Select Yes or No

HSA Plan type

Single

Family

Select an HSA plan type

Personal Information (Account Holder)

First name

Please enter the first name of the account holder

Middle name
(optional)

Please enter the middle name of the account holder

Last name

Please enter the last name of the account holder

Mailing Address 1

Please enter the street address of the account holder

Mailing Address 2
(optional)

Please enter the street address of the account holder

Mailing Address City

Please enter the mailing address city of the account holder

Mailing Address State

Please select the mailing address state of the account holder

Mailing Address Zip

Please enter the 5-digit mailing address zip of the account holder. (ex: 45227)

Social Security Number

Please use the format 999-99-9999

Date of Birth
(mm/dd/yyyy)

Invalid Date

Primary phone
(Best contact number)

Invalid Phone

Work phone
(optional)

Invalid Phone

Invalid Email

Employer Name

Please enter the name of your employer

4 digit PIN
(For your HSA Debit Card)

Invalid PIN. Must be 4 digits.

Drivers License Number

Drivers License State

Drivers License Issue Date (mm/dd/yyyy)

Must be mm/dd/yyyy

Drivers License Expiration Date
(mm/dd/yyyy)

Must be mm/dd/yyyy

Are you married?

Yes

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