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For detailed information about tax reporting for your HSA, visit the IRS Web site or consult with your tax advisor.

NEED TO KNOW

Each state decides whether to follow federal tax guidelines for HSAs or create its own.

Find out what your state requires

IRS Forms

There are three tax forms you'll need to file your taxes:

IRS Form 1099-SA(PDF)
This form provides you with the total distributions that were made from your HSA. You will receive a separate 1099-SA for each type of distribution you had in that tax year. The five types of distributions are normal, excess contribution removal, death, disability and prohibited transaction. This form is mailed at the end of January. If you did not have distributions during the tax year, you will NOT receive a 1099. Retain a copy for your records.

Action Required: Use this form to fill out Form 8899 and retain it for your records.

IRS Form 8889 (PDF)
File this form with your income taxes to report year-to-date contributions and distributions from your HSA. You can get this information by logging into your account and selecting Transactions or eStatements.

IRS Form 5498-SA (PDF)
This form informs you of the contributions made to your HSA in that particular tax year. Because you can make contributions to your HSA for a tax year until April 15 of the following year, this form is sent out in May. Retain a copy for your records.

Action Required: Retain this form for your records. Consult it as needed for any tax filing needs. You do not need to attach a copy of this form with your tax return. (Report HSA contributions on Form 8889 at tax time.)

How to Read Form 5498-SA

Box Number	Information included
Box 2	Box 2 shows the total contributions made to your HSA during the tax year covered by the form. This includes: Contributions made for the tax year covered by the form. Contributions made between January 1 and April 15 of the tax year covered by the form that were designated as prior tax year contributions. Transfers from your IRA to fund your HSA that were made in the tax year covered by the form.
Box 3	Box 3 reflects total contributions made in the current year that were for the tax year covered by the form.
Box 4	Box 4 includes: Rollovers from another HSA to your HSA that were made in the tax year covered by the form. Transfers from an FSA or HRA to your HSA that were made in the tax year covered by the form.
Box 5	Box 5 shows the fair market value (balance) of your HSA at the end of the tax year covered by the form.

Please note, excess contribution returns do not lower the reported totals on your 5498-SA. They are reflected on a separate 1099-SA for the tax year they are associated with.

Additional information about the tax treatment of your HSA contributions is available at the IRS website or from your tax professional.

Health savings accounts (HSAs) are individual accounts offered by OptumHealth Bank^SM, Member FDIC, and are subject to eligibility and restrictions, including but not limited to restrictions on distributions for qualified medical expenses set forth in section 213(d) of the Internal Revenue Code. This communication is not intended as legal or tax advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax treatment, and restrictions. Federal and state laws and regulations are subject to change.

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