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If I enroll in the State HDHP midyear, can I use my HSA to cover expenses incurred earlier in the year?

No. There may be a gap between coverage under the State HDHP and access to your HSA. Health plan coverage begins with the start of a pay period, but the HSA can't be opened until the first day of a month once HDHP coverage is effective. For example, if your State HDHP enrollment is effective March 7, the HSA will open April 1. Expenses incurred before April 1 cannot be paid or reimbursed from the HSA.