Form 5498-SA reports contributions made to your IRA, Health Savings Account (HSA), Archer Medical Savings Account (MSA), or Medicare Advantage MSA (MA MSA).
Type of Plan
In the program, you will be asked to first choose the type of plan: Self-only or Family
- If you were covered, or considered covered, by a self-only HDHP and a family HDHP at different times during the year, check the box for the plan that was in effect for a longer period.
- If you were covered by both a self-only HDHP and a family HDHP at the same time, you are treated as having family coverage during that period.
- . If, on the first day of the last month of your tax year (December 1 for most taxpayers), you had family coverage, check the “family” box.
HSA Contributions you made for 2021- Pulls to 8889 Line 2, Form 8889
- Include only the amounts you, or others on your behalf, contributed to your HSA in 2021.
- Include contributions made in the current tax year until April 15 that were designated as being for the prior year.
- Example: You made contributions on March 15, 2022 for the 2021 tax year AND indicated the contributions were for tax year 2021.
- Do not include contributions that were already reported on your W-2, rollover contributions or employer contributions.
- Contributions to an employee's account through a cafeteria plan are treated as employer contributions and are not included.
- You cannot include any contributions for any month in which you were enrolled in Medicare
- You cannot include contributions if you are someone else's dependent for 2021.
Number of months during the tax year that were an eligible individual.
Your eligibility is based on your coverage status on the first day of the month.
- Use the family coverage amount if you or your spouse had an HDHP with
family coverage. Disregard any plan with self-only coverage.
- If you are eligible to contribute to an HSA on the first day of the last month of your tax
year, you are considered eligible for the entire year, provided you stay enrolled in an HSA
qualifying HDHP. For example, you are eligible to contribute to an HSA by December 1, 2020
and stay eligible through December 31, 2021.
Amount you and your employer contributed to your Archer MSAs for 2021 from Form 8853, lines 3 and 4. If you and your spouse had family coverage under an HDHP at any time during the tax year, also include any amount contributed to your spouse's Archer MSA. Pulls to 8889 Line 4, Form 8889
- Include only the amounts that you and your employer contributed to your ARCHER MSA.
Amount to Adjust Employer Contributions made to your HSA(s) for 2021 - Pulls to 8889 Line 9
- If either of the following apply, complete the Employer Contribution Worksheet to figure the amount to enter on this line
- Employer contributions for 2020 are included in the amount reported in box 12 of Form W-2 with code W.
- Employer contributions for 2021 are made in 2022.
- We will automatically pull your employer contributions from your W-2 (Box 12 Code W) .DO NOT enter amounts from your W-2.
- If your employer made excess contributions, you may have to report the excess as income.
Qualified HSA Funding Distributions from IRA or ROTH IRA - Pulls to 8889 Line 10, Form 8889
A distribution from your traditional IRA or Roth IRA to your HSA in a direct trustee-to-trustee transfer is called an HSA funding distribution. These funds are not being distributed from your HSA, but rather are being distributed from your IRA and contributed to your HSA.
- The distribution reduces the amount that can be contributed to your HSA by you and from other
sources (including employer contributions).
- The qualified HSA funding distribution is not included in your income, it is not deductible.
- You can make only one qualified HSA funding distribution during your lifetime. See the 8889 instructions for exceptions and more information.
- Federal Section
- Health Savings Account