Horizon MyWay
Access printable forms that you can use to manage your Horizon MyWay account.
Horizon MyWay Health Savings Account (HSA) Withdrawal Request
Used for requesting distribution from a Health Savings Account (HSA).
ID: X22165 (11/18)
Access printable forms that you can use to manage your Horizon MyWay account.
Used for requesting distribution from a Health Savings Account (HSA).
ID: X22165 (11/18)
Applicable Products:
Commercial PPO/EPO &
Exchange POS/EPO
Applicable Products:
Commercial HMO & POS
