Instructions for 1099-SA - Form 1099-SA
Form 5498-SA and Form 5498-SA Instructions

Overview 1099-Sa

The Instructions are on a 2 page pdf file.

File form 1099-SA, Distributions 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.

Download and print Form 1099-SA  Instructions and Form 5498-SA Instructions.
Download and print Form 1099 SA - Download and print Form 5498-SA. (Not for filing)

The sections to fill out on the Form 1099-SA are:

• Trustee's/Payer's - Name, address, city , state etc. and telephone number


• Payer's Federal Identification Number


• Recipients Identification number


• Recipients name, address, Apt #, city, state, zip


• Account number (see Instructions)

1. Gross distribution


2. Earnings on excess cont.


3. Distribution Code


4. FMV on date of death


5. Choose HSA - Archer MSA - MA MSA

Form 5498-SA

The sections to fill out on the Form 5498 are:

• Trustee's name, street address, city, state, and Zip


• Trustee's federal ID number


• Participant's social security number


• Participants name, street address, Apt #, city, state, and zip


• Account number (see instructions)

1. Employee or self-employed person's Archer MSA contributions made in (year)
   and (following year) for (year).


2. Total contributions mad in (year).


3. Total HSA or Archer MSA contributions made in following year) for (current year).


4. Rollover contributions.


5. Fair market value of HSA, Archer MSA, or MA MSA.


6. Tick Box - HSA - Archer MSA - MA MSA.

You can avoid the paper problems and use