Health Savings Account (HSA)

All HSA Distributions must be reported on the tax return.

You must file Form 8889 if any of the following applies:

• You or (someone on your behalf, including your employer) made contributions in the current tax year to your HSA.

• You received HSA distributions in the current tax year.

• You must include certain amounts in income because you failed to be an eligible individual during the testing period.

• You acquired an interest in an HSA because of the death of the account beneficiary.

Distributions that qualify as tax-free:

Add the "HSA Distribution Page" and enter the Unreimbursed Qualified Medical Expenses amount of the HSA Distribution (if applicable).

Returns filing Married Filing Joint are required to complete both the Taxpayer and the Spouse sections. (Spouse section not shown).

HDHP Coverage for Taxpayer/Spouse as of December 1, 2023:

Select the type of High Deductible Health Plan (HDHP) coverage had in the prior year (current tax year). You will select from the following:

• • No Taxpayer HSA/No Spouse HSA

  • Self-Only

  • Family

  • None

Taxpayer/Spouse HDHP Status Change:

Select the applicable answer regarding Taxpayers/Spouses HDHP Coverage status change in the prior year (current tax year).

(picture shown is the 2023 Tax Year page and may not reflect current tax year)

Taxpayer's/Spouses HSA Contributions Made for Current Tax Year:

Only enter contributions made in the prior year (current tax year of return).

Taxpayer's/Spouses HSA Employer Contributions:

Employer Contributions from Form W-2 (Box 12, Code W) will be carried over and display here.

Amount of Employer Contributions for Last Tax Year:

Enter here the amount of the Employer Contributions included in Form W-2 Box 12 (displayed above) that are for a Prior Year Contribution (last years).

Amount of Employer Contributions for Next Tax Year (actual current year):

Enter here the amount of the Employer Contributions included in Form W-2 Box 12 (displayed above) that are for Current Year - Next Year Contribution.

Taxpayer's/Spouses Qualified HSA Funding Distributions:

Traditional & Roth IRA funding distributions to the HSA in a direct trustee-to-trustee transfer. This does not include SEP IRAs or SIMPLE IRAs.