Instructions For Forms 1099-Sa And 5498-Sa - 2014
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Department of the Treasury
Internal Revenue Service
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
Section references are to the Internal Revenue Code unless
mistake. For example, the account beneficiary reasonably, but
otherwise noted.
mistakenly, believed that an expense was a qualified medical
expense and was reimbursed for that expense from the HSA. The
Future Developments
account beneficiary then repays the mistaken distribution to the
HSA.
For the latest information about developments related to Forms
1099-SA and 5498-SA and their instructions, such as legislation
Under these circumstances, the mistaken distribution is not
enacted after they were published, go to
included in gross income, is not subject to the additional 20% tax,
and
and the repayment is not subject to the excise tax on excess
contributions. Do not treat the repayment as a contribution on Form
What's New
5498-SA.
Truncating recipient's identification number on paper payee
As the trustee or custodian, you do not have to allow
statements. Pursuant to proposed regulations § 301.6109-4
beneficiaries to return a mistaken distribution to the HSA.
TIP
(REG-148873-09), all filers of these forms may truncate a recipient's
However, if you do allow the return of the mistaken
(Form 1099-SA) or participant's (Form 5498-SA) identification
distribution, you may rely on the account beneficiary's statement that
number, such as their social security number (SSN), individual
the distribution was in fact a mistake. See Notice 2004-50, 2004-33
taxpayer identification number (ITIN), or adoption taxpayer
I.R.B. 196, Q/A-76, available at
identification number (ATIN), on payee statements. See part M in
ar08.html. Do not report the mistaken distribution on Form 1099-SA.
the 2014 General Instructions for Certain Information Returns.
Correct any filed Form 1099-SA with the IRS and the account
beneficiary as soon as you become aware of the error. See
Reminder
Corrected Returns on Paper Forms in the 2014 General Instructions
for Certain Information Returns for more information.
General instructions. In addition to these specific instructions, you
should also use the 2014 General Instructions for Certain
Death of Account Holder
Information Returns. Those general instructions include information
about the following topics.
Archer MSAs and MA MSAs. When the account holder dies and
Who must file (nominee/middleman).
the designated beneficiary is the spouse:
When and where to file.
The spouse becomes the account holder of the Archer MSA,
Electronic reporting requirements.
An MA MSA is treated as an Archer MSA of the spouse for
Corrected and void returns.
distribution purposes, and
Statements to recipients.
Distributions from these accounts are subject to the rules that
Taxpayer identification numbers.
apply to Archer MSAs.
Backup withholding.
If the designated beneficiary is not the spouse or there is no
Penalties.
named beneficiary, the account ceases to be an MSA as of the date
Other general topics.
of death and the fair market value (FMV) on that date is reported.
You can get the general instructions from
If there is more than one recipient, the FMV should be allocated
form1099sa, form5498sa, or by calling
among them, as appropriate.
1-800-TAX-FORM (1-800-829-3676).
If the beneficiary is the estate, enter the estate's name and
Specific Instructions for Form
taxpayer identification number (TIN) in place of the recipient's on the
form.
1099-SA
Distribution in year of death. If you learn of the account
holder's death and make a distribution to the beneficiary in the year
File Form 1099-SA, Distributions From an HSA, Archer MSA, or
of death, issue a Form 1099-SA and enter in:
Medicare Advantage MSA, to report distributions made from an
Box 1, the gross distribution;
HSA, Archer MSA, or Medicare Advantage MSA (MA MSA). The
Box 3, code 4 (see Box 3. Distribution Code, later); and
distribution may have been paid directly to a medical service
Box 4, the FMV of the account on the date of death.
provider or to the account holder. A separate return must be filed for
Distribution after year of death. If you learn of the death of the
each plan type.
account holder and make a distribution after the year of death, issue
Transfers. Do not report a trustee-to-trustee transfer from one
a Form 1099-SA in the year you learned of the death of the account
Archer MSA or MA MSA to another Archer MSA or MA MSA, one
holder. Enter in:
Archer MSA to an HSA, or from one HSA to another HSA. For
Box 1, the gross distribution;
reporting purposes, contributions and rollovers do not include
Box 3, one of the following codes (see Box 3. Distribution Code,
transfers.
later):
1—if the beneficiary is the spouse,
HSA mistaken distributions. If amounts were distributed during
4—if the beneficiary is the estate, or
the year from an HSA because of a mistake of fact due to
6—if the beneficiary is not the spouse or estate;
reasonable cause, the account beneficiary may repay the mistaken
Box 4, the FMV of the account on the date of death, reduced by
distribution no later than April 15 following the first year the account
any payments from the HSA made for the decedent's qualified
beneficiary knew or should have known the distribution was a
medical expenses, if paid within one year after death.
Sep 24, 2013
Cat. No. 38470S
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