---
title: High Deductible Health Plan (HDHP) & HSA Enrollment Form Template | Paperform
description: Professional HDHP and HSA enrollment form template for HR teams. Verify eligibility, manage contribution limits, check coverage compatibility, and streamline benefits enrollment.
url: "https://paperform.co/templates/high-deductible-health-plan-hdhp-hsa-enrollment-form"
type: static
generatedAt: "2026-03-28T00:44:05.281Z"
---

[← Back to free form templates](/templates/)    ![High Deductible Health Plan (HDHP) & HSA Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/high-deductible-health-plan-hdhp-hsa-enrollment-form.png)
    [Preview](https://_preview.paperform.co/ai-template/high-deductible-health-plan-hdhp-hsa-enrollment-form) [Use this template for free](/create?ai-template=high-deductible-health-plan-hdhp-hsa-enrollment-form)    [Human Resources Forms](/templates/category/hr/) [Business](/templates/industry/business/)[Human Resources](/templates/industry/human-resources/) [Office Manager](/templates/role/office-manager/)[HR Manager](/templates/role/hr-manager/)[Manager](/templates/role/manager/)[HR Specialist](/templates/role/hr-specialist/)     About this free form template
### Simplify HDHP and HSA Enrollment for Your Team

Managing health plan enrollment and HSA eligibility verification can be time-consuming for HR teams, especially when dealing with compliance requirements, contribution limits, and coverage compatibility checks. This **High Deductible Health Plan (HDHP) and HSA Enrollment Form** template streamlines the entire process into one professional, user-friendly form.

Built for HR managers, benefits administrators, and small to medium-sized businesses, this template captures all the essential information you need—from personal details and HDHP plan selection to HSA contribution elections and Medicare enrollment verification. The form uses conditional logic to show relevant fields based on employee responses, ensuring a smooth experience while maintaining accuracy.

With Paperform, you can customize this template to match your company branding, embed it on your intranet, and automatically route submissions to your benefits team or HRIS. Plus, you can connect it to [Stepper](https://stepper.io) to automate follow-up workflows—like sending confirmation emails, creating tasks for benefits coordinators, or syncing enrollment data with your payroll system.

Whether you're managing open enrollment season or onboarding new hires, this template helps you collect complete, compliant information while saving time and reducing administrative headaches. Everything you need to verify HSA eligibility, confirm coverage compatibility, and process HDHP enrollment decisions in one place.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
 ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg)
 ![G2 - 4.8 out of 5](/images/g2-st.jpg)
  [Try Paperform free now](/register)
## More templates like this
  [![Employee Benefits Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/employee-benefits-enrollment-form.png)

### Employee Benefits Enrollment Form

Streamline your employee benefits enrollment process with plan comparisons, health insurance selections, HSA/FSA calculators, and beneficiary designations—all in one comprehensive form.](/templates/employee-benefits-enrollment-form/)
[![Flexible Work Arrangement Compensation Adjustment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/flexible-work-arrangement-compensation-adjustment-form.png)

### Flexible Work Arrangement Compensation Adjustment Form

A comprehensive form for employees requesting flexible work arrangements with compensation adjustments, including schedule changes, salary pro-ration for reduced hours, and benefits impact assessment.](/templates/flexible-work-arrangement-compensation-adjustment-form/)
[![Identity Theft Protection Benefit Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/identity-theft-protection-benefit-enrollment-form.png)

### Identity Theft Protection Benefit Enrollment Form

Enroll in your employer's identity theft protection benefit program with comprehensive monitoring, credit freeze assistance, resolution support, and optional family coverage.](/templates/identity-theft-protection-benefit-enrollment-form/)
[![Paid Parental Leave Request Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/paid-parental-leave-request-form.png)

### Paid Parental Leave Request Form

A comprehensive parental leave request form with FMLA eligibility checks, state benefit coordination, leave duration calculations, and return-to-work planning for expecting or new parents.](/templates/paid-parental-leave-request-form/)
[![Pet Insurance Benefit Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/pet-insurance-benefit-enrollment-form.png)

### Pet Insurance Benefit Enrollment Form

Enroll your pet in comprehensive insurance coverage with flexible plan options, calculate monthly premiums, and authorize convenient payroll deductions.](/templates/pet-insurance-benefit-enrollment-form/)
[![Professional Development Stipend Request Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/professional-development-stipend-request-form.png)

### Professional Development Stipend Request Form

A comprehensive form for employees to request professional development funding for conferences, courses, and training programs with budget tracking and knowledge sharing commitments.](/templates/professional-development-stipend-request-form/)
[![Profit Sharing Plan Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/profit-sharing-plan-enrollment-form.png)

### Profit Sharing Plan Enrollment Form

A comprehensive profit sharing enrollment form that verifies eligibility, explains vesting schedules, captures distribution preferences, and projects annual contributions for employees joining their company's profit sharing plan.](/templates/profit-sharing-plan-enrollment-form/)
[![Student Loan Repayment Assistance Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/student-loan-repayment-assistance-enrollment-form.png)

### Student Loan Repayment Assistance Enrollment Form

Enroll in your employer's student loan repayment assistance program with this comprehensive form that captures loan servicer details, contribution preferences, and acknowledges program terms and tax implications.](/templates/student-loan-repayment-assistance-enrollment-form/)
[![Accessibility Software & Hardware Request Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/accessibility-software-hardware-request-form.png)

### Accessibility Software & Hardware Request Form

Request assistive technology, accessibility software, and adaptive hardware to support workplace accommodations and ensure ADA compliance.](/templates/accessibility-software-hardware-request-form/)
[![Adoption Assistance Benefit Application Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/adoption-assistance-benefit-application-form.png)

### Adoption Assistance Benefit Application Form

A comprehensive application form for employees seeking adoption assistance benefits, including expense reimbursement, legal fee coverage, and time-off coordination.](/templates/adoption-assistance-benefit-application-form/)
[![Argentina Employee Benefits Cafeteria Plan Election Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/argentina-employee-benefits-cafeteria-plan-election-form.png)

### Argentina Employee Benefits Cafeteria Plan Election Form

A comprehensive employee benefits cafeteria plan election form designed for Argentine companies to capture flexible compensation choices with AFIP-compliant reporting and CUIT validation.](/templates/argentina-employee-benefits-cafeteria-plan-election-form/)
[![Argentina Employee Referral Bonus Form with AFIP Reporting](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/argentina-employee-referral-bonus-form-with-afip-reporting.png)

### Argentina Employee Referral Bonus Form with AFIP Reporting

A comprehensive employee referral bonus form for Argentine companies with AFIP supplemental compensation reporting and tax withholding compliance for CUIT registered employees.](/templates/argentina-employee-referral-bonus-form-with-afip-reporting/)