Form 1099-SA

What is Form 1099-SA?

Form 1099-SA, to report the distributions made from an,

  • Health savings account (HSA).
  • Archer Medical Savings Account (Archer MSA).
  • Medicare Advantage Medical Savings Account (MA MSA).

The distribution may have been paid directly to a medical service provider or to the account holder and available at the end of January. A separate return must be filed for each plan type.

HSA are reported on Box 12 with code W in the W-2 Form, which includes the medical expenses. The filer may file more than one Form 1099-SA when they have multiple accounts. The form includes the total amount of the distribution, the total earnings distributed with any excess HSA or Archer MSA contributions, appropriate distribution code for the types of distribution, FMV of the account on the date of death, and a checkbox to choose the type of distribution or the type of account to be chosen by the filer. The distributions will be taxed at a rate of 20%.

Distribution Codes for Distributions from HSAs, Archer MSAs, and Medicare Advantage MSAs:

Code Explanation
1—Normal distributions 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.
2—Excess contributions Use this code for distributions of excess HSA or Archer MSA contributions to the account holder.
3—Disability 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.
5—Prohibited transaction See sections 220(e)(2) and 223(e)(2).
6—Death distribution after a year of death to a non-spouse beneficiary Use this code for payments to a decedent's non-spouse beneficiary, other than an estate, after the year of death. Do not use with code 4.

Note: If the funds are used for non-medical purposes, they will not be deemed eligible to be tax-free.

1099-SA Form

1099-SA Form