Select language

Form 1099-SA

  1. Country USA
  2. Language English
  3. Activity Taxes
  4. Department Internal Revenue Service
Form 1099-SA

Distributions From an HSA, Archer MSA, or Medicare Advantage MSA

Rev. November 2019

Form 1099-SA reports distributions from Health Savings Accounts (HSAs), Archer MSAs, and Medicare Advantage MSAs. Trustees or payers must provide this form to recipients and the IRS. Recipients report these distributions on their individual income tax returns.

Instructions

  • Instructions for Forms 1099-SA and 5498-SA - Instructions for Forms 1099-SA and 5498-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA, and HSA, Archer MSA, or Medicare Advantage MSA Information

Search tags

FAQ
  • Do I need to file Form 5498-SA if my HSA or Archer MSA had no contributions for the year?

    If there were no contributions made during the year, you are not required to file Form 5498-SA with the IRS. However, you must furnish a statement of the December 31, 2023, FMV of the participant's account to the participant by January 31, 2024. If no statement is provided, the participant may be required to file Form 5498-SA with the IRS.

  • What information should be reported in Box 2 of Form 5498-SA?

    Box 2 of Form 5498-SA is used to report total HSA or Archer MSA contributions made during the current taxable year, including qualified HSA funding distributions received from an IRA.

  • What information should be reported in Box 1 of Form 5498-SA?

    Box 1 of Form 5498-SA is used to report Archer MSA contributions made by an employee or self-employed person for the current and prior year.

  • What is the due date for filing Form 5498-SA with the IRS?

    Form 5498-SA must be filed with the IRS by May 31 following the calendar year for which the information is being reported.

  • Who must file Form 5498-SA?

    Trustees or custodians of HSAs and Archer MSAs are required to file Form 5498-SA with the IRS and furnish a statement to each participant (or beneficiary) by May 31 following the calendar year for which the information is being reported.

  • What should I do if there were both HSA and Archer MSA contributions made during the year?

    If you are filing Form 5498-SA for an HSA and an Archer MSA, you must report contributions for each plan type separately. Report contributions to the HSA in box 2a, and contributions to the Archer MSA in box 3.

  • What forms are required for reporting contributions, distributions, and fair market values for HSAs and Archer MSAs?

    Form 5498-SA is used to report contributions, distributions, and fair market values for Health Savings Accounts (HSAs) and Archer Medical Savings Accounts (Archer MSAs).

  • Can I designate an account number for multiple Forms 5498-SA?

    Yes, you may designate a unique account number for each Form 5498-SA that you file. This will help to prevent confusion when processing multiple forms.

  • What information is reported in Box 4 of Form 5498-SA?

    In Box 4, you report rollover contributions received during the year. These are contributions that were made to another HSA, Archer MSA, or MA MSA and rolled over to the current plan.

HOW TO

How to fill out Form 1099-SA for free, online in 3 easy steps:

  1. 1
    Open form template in editor
    Click on the “Get this template” button.
  2. 2
    Fill out Form 1099-SA
    Wait a moment and you will be redirected to our online PDF Filler app.
  3. 3
    Download file
    Download your completed Form 1099-SA for free. You can also save it to a cloud storage.
Formize PDF Filler app
ABOUT

Internal Revenue Service (IRS) Forms

Form 1099-SA is one of the official tax forms used in the United States to report income, claim deductions and credits, calculate tax liability, and fulfill other tax-related obligations. The IRS is the federal agency responsible for administering and enforcing the internal revenue laws in the United States.

Here are some examples of Internal Revenue Service forms:

Form 1040: This is the primary individual income tax return form used by most taxpayers. It is used to report various types of income, claim deductions and credits, calculate tax liability, and determine whether a taxpayer owes additional tax or is entitled to a refund.

Form 1099: There are different variations of Form 1099, such as 1099-MISC, 1099-INT, 1099-DIV, etc. These forms are used to report income received by individuals or businesses from various sources other than employment, such as self-employment income, interest income, dividend income, and rental income.

Form W-2: This form is used by employers to report wages paid to employees and the taxes withheld from their pay. Employees use the information on Form W-2 to complete their individual tax returns.

Form 941: Employers use this form to report employment taxes, including federal income tax withheld, Social Security tax, and Medicare tax, for their employees.

Form 1065: This form is used by partnerships to report their income, deductions, and tax liability. Partnerships themselves do not pay income tax; instead, the partners report their share of partnership income on their individual tax returns.

Form 1120: This is the corporate income tax return form used by C corporations to report their income, deductions, and tax liability.

Form 990: This form is used by tax-exempt organizations, such as nonprofits and charities, to report their financial information, activities, and compliance with tax laws.

Form 8862: This form is used by taxpayers who previously claimed the Earned Income Tax Credit (EITC) but had it disallowed, and now want to claim it again.

These are just a few examples of the numerous IRS forms that exist to fulfill various tax-related obligations. The specific forms required for an individual or business depend on their unique circumstances, income sources, and deductions. It's advisable to consult the official website of the Internal Revenue Service (www.irs.gov) or seek professional tax advice to obtain accurate and up-to-date information regarding the specific IRS forms relevant to your tax situation.

FEATURES

PDF Filler

The easiest way to fill Form 1099-SA online

  • Quickly fill out Form 1099-SA
    Looking for a way to quickly fill Form 1099-SA online? With our online free PDF form filler, you’ll know how to how to edit and fill this pdf document in less than a minute.
  • Easy to use online PDF editor
    Fed up with printing out PDF files so you can edit them, before rescanning and sending them back? Edit PDF documents for free online. Use our online pdf editor to save time and paper.
  • Great tools, all platforms
    Wondering how to fill in Form 1099-SA on a Mac, or maybe how to use a PDF filler free? Our online PDF tools work on all platforms.
  • Secure file storage
    Completed "Form 1099-SA" files are stored in a secured database managed by Amazon Cloud hosting. You can delete your files from our system anytime. In any case, these files are automatically deleted after 24 hours.
  • Chat with Form 1099-SA
    Chat with "Form 1099-SA" on Chatize that is a free PDF reader assistant. Ask questions and get answers from "Form 1099-SA". Just click on Chat With Document button above.

Delete filling session

Delete the selected filling session? In this case, your progress in completing the form will be lost.

Delete editing session

Delete the selected editing session? In this case, your progress in creating and editing the form will be lost.