OMB control number
HSA, Archer MSA, or Medicare Advantage MSA Information
OMB 1545-1518 · TREAS/IRS.
Internal Revenue Code (IRC) Sections 138(e) and 220(h) requires trustees to report to the Internal Revenue Service (IRS) and medical savings accountholders contributions to and the year-end fair market value of any contributions made to an Archer or Medicare Advantage medical savings account (MSA). Congress requires Treasury to report to them the total contributions made to an MSA for the current tax year. IRC Section 223(h) requires the reporting of contributions to and the year-end fair market value of health savings accounts (HSA) for tax years beginning after December 31, 2003. Form 5498-SA, is used to report contributions to and rollovers into an Archer MSA, Medicare Advantage MSA, or HSA.
The latest form for HSA, Archer MSA, or Medicare Advantage MSA Information expires 2028-05-31 and can be found here.