Federal Form 1099-Sa Instructions
For the latest information about developments related to Forms 1099-SA and 5498-SA and their instructions, such as legislation enacted after they were published, go to
Pilot program for truncating an individual's identifying number on paper payee statements has ended.
Filers of Form 1099-H must show the recipient's complete identifying number on all copies of the form.
In addition to these specific instructions, you should also use the 2013 General Instructions for Certain Information Returns. Those general instructions include information about the following topics.
- Backup withholding.
- Electronic reporting requirements.
- Who must file (nominee/middleman).
- When and where to file.
- Taxpayer identification numbers.
- Statements to recipients.
- Corrected and void returns.
- Other general topics.
You can get the general instructions from
, or by calling 1-800-TAX-FORM (1-800-829-3676).
Specific Instructions for Form 1099-SA
File Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA, to report distributions made from an HSA, Archer MSA, or Medicare Advantage MSA (MA MSA). The distribution may have been paid directly to a medical service provider or to the account holder. A separate return must be filed for each plan type.
Do not report a trustee-to-trustee transfer from one Archer MSA or MA MSA to another Archer MSA or MA MSA, one Archer MSA to an HSA, or from one HSA to another HSA. For reporting purposes, contributions and rollovers do not include transfers.
HSA mistaken distributions.
If amounts were distributed during the year from an HSA because of a mistake of fact due to reasonable cause, the account beneficiary may repay the mistaken distribution no later than April 15 following the first year the account beneficiary knew or should have known the distribution was a mistake. For example, the account beneficiary reasonably, but mistakenly, believed that an expense was a qualified medical expense and was reimbursed for that expense from the HSA. The account beneficiary then repays the mistaken distribution to the HSA.
Under these circumstances, the distribution is not included in gross income, is not subject to the additional 20% tax, and the payment is not subject to the excise tax on excess contributions. Do not treat the repayment as a contribution on Form 5498-SA.
TIP: As the trustee or custodian, you do not have to allow beneficiaries to return a mistaken distribution to the HSA. However, if you do allow the return of the mistaken distribution, you may rely on the account beneficiary's statement that the distribution was in fact a mistake. See Notice 2004-50, 2004-33 I.R.B. 196, Q/A-76, available at
. Do not report the mistaken distribution on Form 1099-SA. Correct any filed Form 1099-SA with the IRS and the account beneficiary as soon as you become aware of the error. See Corrected Returns on Paper Forms in the 2013 General Instructions for Certain Information Returns for more information.
Death of Account Holder
Archer MSAs and MA MSAs.
When the account holder dies and the designated beneficiary is the spouse:
- The spouse becomes the account holder of the Archer MSA,
- An MA MSA is treated as an Archer MSA of the spouse for distribution purposes, and
- Distributions from these accounts are subject to the rules that apply to Archer MSAs.
If the designated beneficiary is not the spouse or there is no named beneficiary, the account ceases to be an MSA as of the date of death and the fair market value (FMV) on that date is reported.
If there is more than one recipient, the FMV should be allocated among them, as appropriate.
If the beneficiary is the estate, enter the estate's name and taxpayer identification number (TIN) in place of the recipient's on the form.
Distribution in year of death.
If you learn of the account holder's death and make a distribution to the beneficiary in the year of death, issue a Form 1099-SA and enter in:
- Box 1, the gross distribution;
- Box 3, code 4 (see page 2); and
- Box 4, the FMV of the account on the date of death.
Distribution after year of death.
If you learn of the death of the account holder and make a distribution after the year of death, issue a Form 1099-SA in the year you learned of the death of the account holder. Enter in:
When the account holder dies and:
- The designated beneficiary is the surviving spouse, the spouse becomes the account holder of the HSA.
- The spouse is not the designated beneficiary, the account ceases to be an HSA on the date of the account holder's death. The FMV of the account as of the date of death is required to be reported in box 4. Follow the rules and coding above under Distribution in year of death and Distribution after year of death.
Statements to Recipients
If you are required to file Form 1099-SA, you must provide a statement to the recipient. For more information about the requirement to furnish a Form 1099-SA or acceptable substitute statement to recipients, see part M in the 2013 General Instructions for Certain Information Returns.
The account number is required if you have multiple accounts for a recipient for whom you are filing more than one Form 1099-SA. Additionally, the IRS encourages you to designate an account number for all Forms 1099-SA that you file. See part L in the 2013 General Instructions for Certain Information Returns.
Box 1. Gross Distribution
Enter the total amount of the distribution. Include any earnings separately reported in box 2. You are not required to determine the taxable amount of a distribution. Do not report a negative amount in box 1. Do not report the withdrawal of excess employer contributions (and the earnings on them) returned to an employer as a distribution from an employee's HSA. Do not report excess MA MSA contributions returned to the Secretary of Health and Human Services or his or her representative.
Box 2. Earnings on Excess Contributions
Enter the total earnings distributed with any excess HSA or Archer MSA contributions returned by the due date of the account holder's tax return. Include this amount in box 1. Report earnings on other distributions only in box 1.
TIPFor HSAs and Archer MSAs, if you are reporting earnings on a distribution of excess contributions, use the method under Regulations section 1.408-11 for calculating the net income attributable to IRA contributions that are distributed as a returned contribution. If the amount in box 2 includes earnings on excess contributions, enter distribution code 2 in box 3.
Box 3. Distribution Code
Enter the appropriate distribution code from the list below that shows the type of distribution.
Use this code for normal distributions to the account holder and any direct payments to a medical service provider. Use this code if no other code applies. Also, see Distribution after year of death on page 1.
Use this code for distributions of excess HSA or Archer MSA contributions to the account holder.
Use this code if you made distributions after the account holder was disabled (see section 72(m)(7)).
|4-Death distribution other than code 6
||Use this code for payments to a decedent's estate in the year of death. Also use this code for payments to an estate after the year of death. Do not use with code 6. See Death of Account Holder on page 1.
See sections 220(e)(2) and 223(e)(2).
6-Death distribution after year of death to a nonspouse beneficiary
Use this code for payments to a decedent's nonspouse beneficiary, other than an estate, after the year of death. Do not use with code 4.
Box 4. FMV on Date of Death
Enter the FMV of the account on the date of death. See Death of Account Holder on page 1.
Box 5. Checkbox
Check the box to indicate if this distribution was from an HSA, Archer MSA, or MA MSA.