Instructions For Form 8889 - Health Savings Accounts

on a different allocation (such as

allocated to your spouse). Your

If your employer made excess

allocating nothing to one spouse).

spouse will show $900 on line 6.

contributions, you may have to report

Enter your allocable share on line 6.

the excess as income. See Excess

•

Line 7

Employer Contributions beginning

If you were not treated as having

below for details.

family coverage for each month you

Additional Contribution Amount

were an eligible individual, use the

Line 11

following steps to determine the

If, at the end of 2006, you were age

If you or someone on your behalf (or

amount to enter on line 6.

55 or older and married, use the

your employer) contributed more to

Additional Contribution Amount

Step 1. Refigure the contribution

your HSA than is allowable, you may

Worksheet below if both of the

limit that would have been entered on

have to pay an additional tax on the

following apply.

line 5 if you had entered on line 3 the

excess contributions. Figure the

1. You or your spouse had family

total of the worksheet amounts only

excess contributions using the

coverage under an HDHP on the first

for the months you were treated as

instructions below. See Form 5329,

day of the month.

having family coverage. When

Additional Taxes on Qualified Plans

2. You were not enrolled in

refiguring line 5, use the same

(Including IRAs) and Other

Medicare for the month.

amount you previously entered on

Tax-Favored Accounts, to figure the

line 4.

additional tax.

Enter the result on line 7.

Step 2. Divide the refigured

Excess Contributions You Make

If items (1) and (2) apply to all

contribution limit from Step 1 equally

To figure your excess contributions

TIP

months during 2006, enter

between you and your spouse, unless

(including those made on your

$700 on line 7.

you both agree on a different

behalf), subtract your deductible

allocation (such as allocating nothing

contributions (line 11) from your

Additional Contribution Amount

to one spouse).

actual contributions (line 2). However,

Worksheet

you can withdraw some or all of your

Step 3. Subtract the part of the

1. $ 700 × number of months

excess contributions for 2006 and

contribution limit allocated to your

eligible . . . . . . . . . . . . . . . . .

they will be treated as if they had not

spouse in Step 2 from the amount

2. Divide line 1 by 12. Enter here

been contributed if:

you previously entered on line 5.

•

and on line 7 . . . . . . . . . . . . .

You make the withdrawal by the

Enter the result on line 6.

due date, including extensions, of

Example. At the end of 2006, you

Example. In 2006, you are an

your 2006 tax return (but see the

were age 55 and married. You had

eligible individual and have self-only

Note on page 5),

•

family coverage under an HDHP from

coverage under an HDHP with a

You do not claim a deduction for

July 1 through December 31, 2006 (6

$1,200 deductible. In March, you get

the amount of the withdrawn

months). You were not enrolled in

married and as of April 1, you have

contributions, and

•

Medicare in 2006. You would enter

family coverage under an HDHP with

You also withdraw any income

an additional contribution amount of

a $2,400 deductible. Neither you nor

earned on the withdrawn

$350 on line 7 ($700 × 6/12).

your spouse were age 55 or older at

contributions and include the

the end of 2006 so you do not qualify

earnings in “Other income” on your

Line 9

for the additional contribution amount.

tax return for the year you withdraw

Your spouse has a separate HSA and

the contributions and earnings.

Employer Contributions

is an eligible individual from April 1

Excess Employer Contributions

through December 31, 2006. The

Employer contributions (including

contribution limit for the 9 months of

contributions through a cafeteria plan)

Excess employer contributions are

family coverage is $1,800 ($2,400 ×

include any amount an employer

the excess, if any, of your employer’s

9/12). You and your spouse can

contributes to any HSA for you for

contributions over your limitation on

divide the $1,800 in any allocation

2006. These contributions should be

line 8. If the excess was not included

you agree to. Your contribution limit

shown in box 12 of Form W-2 with

in income on Form W-2, you must

for the 3 months of self-only coverage

code W. If either of the following

report it as “Other income” on your

is $300 ($1,200 × 3/12). This amount

apply, complete the Employer

tax return. However, you can

is not divided between you and your

Contribution Worksheet below.

withdraw some or all of the excess

•

spouse. If you and your spouse divide

Employer contributions for 2005

employer contributions for 2006 and

the contribution limit for the months of

are included in the amount reported

they will be treated as if they had not

family coverage equally, you will

in box 12 of Form W-2 with code W.

been contributed if:

•

show $1,200 on line 6 ($2,100 from

Employer contributions for 2006

You make the withdrawal by the

your original line 5 minus $900

are made in 2007.

due date, including extensions, of

Employer Contribution Worksheet

Keep for Your Records

1. Enter the employer contributions reported in box 12 of Form W-2, with code W . . . . . . . . . . . . . . . . . . . . . . .

2. Enter employer contributions made in 2006 for tax year 2005 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Enter employer contributions made in 2007 for tax year 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Employer contributions for 2006. Add lines 3 and 4. Enter here and on Form 8889, line 9 . . . . . . . . . . . . . .

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Instructions For Form 8889 - Health Savings Accounts - 2006 Page 4

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