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Form 1099-SA

  1. Country USA
  2. Language English
  3. Activity Taxes
  4. Department Internal Revenue Service
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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

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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.

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ABOUT

Tax forms

Form 1099-SA is one of Tax forms that are documents used to report information about an individual's or business's income, deductions, and tax liability to the relevant tax authority. These forms are necessary to comply with tax laws and fulfill tax obligations. Tax forms vary depending on the country and the specific tax requirements in place. Here are some common types of tax forms:

Individual Tax Forms: These forms are used by individual taxpayers to report their personal income and claim deductions, credits, and exemptions. Examples include the 1040 form in the United States or the Self-Assessment Tax Return form in the United Kingdom.

Business Tax Forms: Business tax forms are used by companies, partnerships, or self-employed individuals to report their business income, expenses, and other tax-related information. Examples include the Schedule C form (Profit or Loss from Business) in the United States or the CT600 form (Company Tax Return) in the United Kingdom.

Payroll Tax Forms: These forms are used by employers to report the wages, salaries, and taxes withheld from their employees' paychecks. Examples include the W-2 form in the United States or the P60 form in the United Kingdom.

Sales Tax Forms: Sales tax forms are used by businesses to report and remit sales tax collected on taxable goods or services. The specific sales tax forms vary by jurisdiction.

Value Added Tax (VAT) Forms: VAT forms are used in countries that impose a value-added tax to report and remit VAT collected on sales and claim VAT credits for purchases. Examples include the VAT return forms used in many countries.

Estimated Tax Forms: Estimated tax forms are used to report and pay estimated taxes on income that is not subject to withholding, such as self-employment income or investment income.

These are just a few examples of the numerous tax forms that may exist. The specific forms required depend on the tax laws and regulations in your country or jurisdiction. It is important to consult the tax authority's guidelines or seek professional advice to determine which forms are applicable to your situation.

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