The following fees apply to your Fifth Third Bank HSA. You shall pay such fees in accordance with the terms of the Health Savings Custodial Account Agreement unless otherwise noted.

Account Basics

One-time Enrollment Fee¹:

• Online (Self) Enrollment: $5.00
• Enrollment by Employer: $10.00
• Paper Application Enrollment: $20.00

Monthly HSA Service Fee²:

• Accounts with a monthly average balance < $4000.00: $3.00
• Accounts with a monthly average balance > or equal to $4000.00: NO CHARGE
• Minimum Deposit Required for Account Opening: $0.00
• ACH Transfers: NO CHARGE

Special Fees

• Check Order (50 checks): $24.99
• Check Writing: NO CHARGE
• Stop Payment: $33.00
• Overdraft: $33.00 per item
• Daily Overdraft Fee³: $8.00
• Copy of a Check: $5.00 per copy
• Copy of a Monthly Statement: $5.00 per copy
• Returned Deposit Check or EFT: $15.00 per item

Other Service Fees

• Monthly Account Statement – Online: NO CHARGE
• Monthly Account Statement – Mailed: NO CHARGE
• First Two Debit Cards: NO CHARGE
• Additional/Replacement Debit Cards: $10.00 per card
• Non Fifth Third ATM transaction (foreign): Assessed by foreign institution
• Account Closure⁴: $25.00*
• Outgoing Rollover Fee⁴: $25.00*

Investment Options

• Mutual Fund Participation Monthly Service Fee⁵: $2.00

Fifth Third Bank may change the amount or type of any of the above fees or add additional fees at any time in accordance with the terms of the Health Savings Custodial Account Agreement.

1. If your account is opened through an Employer-based plan then your Employer or TPA may pay your One-time Enrollment Fee. Please refer to your Employer-provided benefits information to understand if your Employer pays this fee for you.
2. If your account is opened through an Employer-based plan then your Employer or TPA may pay your Monthly HSA Service Fee. Please refer to your Employer-provided benefits information to understand if your Employer pays this fee for you. If your employment is terminated for any reason, you will be responsible for payment of the Monthly HSA Service Fee which is currently $3.00. If you have a monthly average balance of $4,000.00 or more than your $3.00 Monthly HSA Service Fee is waived.
3. Charged for each day your account is overdrawn; not charged if negative balance is eliminated within 3 business days after the day of the overdraft occurrence.
4. Fee is charged and deducted at the time the account is closed/rolled over to another institution. Any account with no transactional activity within 180 days of account opening will automatically be closed. Any account maintaining a $0.00 balance for 16 consecutive months will automatically be closed.

   *The fee will be the greater of $25.00 or the remaining balance in your account at time of closure/rollover request.

5. See individual Prospectus for fees related to each Mutual Fund available through the Fifth Third Bank HSA Investment Options. A balance of $2,000 in the HSA Cash Account is required before investing in mutual funds. An Investment Administration Fee totaling 10 basis points annually will be assessed. Quarterly 2.5 basis points or 0.025% of the total average investment account balance will be applied as a fee to the HSA Cash Account at the end of each calendar quarter.

Additional Disclosures:

Fifth Third Bank does not provide tax or accounting advice. Please consult an accountant or tax advisor for professional advice on these areas.

For a complete list of qualified medical expenses, please visit www.irs.gov.

Mutual Fund investments are not FDIC-Insured, have no bank guarantee, and are subject to investment risk, including possible loss of the principle amount invested.

Deposit account provided by Fifth Third Bank. Member FDIC.

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