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1040ez Form 2011 Printable

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1040ez Form 2011 Printable

1040ez form 2011 printable Publication 501 - Introductory Material Table of Contents What's New Reminders IntroductionOrdering forms and publications. 1040ez form 2011 printable Tax questions. 1040ez form 2011 printable Useful Items - You may want to see: What's New Who must file. 1040ez form 2011 printable   In some cases, the amount of income you can receive before you must file a tax return has increased. 1040ez form 2011 printable Table 1 shows the filing requirements for most taxpayers. 1040ez form 2011 printable Exemption amount. 1040ez form 2011 printable  The amount you can deduct for each exemption has increased. 1040ez form 2011 printable It was $3,800 for 2012. 1040ez form 2011 printable It is $3,900 for 2013. 1040ez form 2011 printable Exemption phaseout. 1040ez form 2011 printable  You lose at least part of the benefit of your exemptions if your adjusted gross income is above a certain amount. 1040ez form 2011 printable For 2013, the phaseout begins at $150,000 for married individuals filing separate returns; $250,000 for single individuals; $275,000 for heads of household; and $300,000 for married individuals filing joint returns or qualifying widow(er)s. 1040ez form 2011 printable See Phaseout of Exemptions , later. 1040ez form 2011 printable Standard deduction increased. 1040ez form 2011 printable   The standard deduction for some taxpayers who do not itemize their deductions on Schedule A of Form 1040 is higher for 2013 than it was for 2012. 1040ez form 2011 printable The amount depends on your filing status. 1040ez form 2011 printable You can use the 2013 Standard Deduction Tables near the end of this publication to figure your standard deduction. 1040ez form 2011 printable Same-sex marriages. 1040ez form 2011 printable . 1040ez form 2011 printable  If you have a same-sex spouse whom you legally married in a state (or foreign country) that recognizes same-sex marriage, you and your spouse generally must use the married filing jointly or married filing separately filing status on your 2013 return, even if you and your spouse now live in a state (or foreign country) that does not recognize same-sex marriage. 1040ez form 2011 printable See Same-sex marriage under Marital Status, later. 1040ez form 2011 printable If you meet certain requirements, you may be able to file amended returns to change your filing status for some earlier years. 1040ez form 2011 printable For details on filing amended returns, see Joint Return After Separate Returns . 1040ez form 2011 printable Reminders Future developments. 1040ez form 2011 printable  Information about any future developments affecting Publication 501 (such as legislation enacted after we release it) will be posted at www. 1040ez form 2011 printable irs. 1040ez form 2011 printable gov/pub501. 1040ez form 2011 printable Taxpayer identification number for aliens. 1040ez form 2011 printable   If you are a nonresident or resident alien and you do not have and are not eligible to get a social security number (SSN), you must apply for an individual taxpayer identification number (ITIN). 1040ez form 2011 printable Your spouse also may need an ITIN if he or she does not have and is not eligible to get an SSN. 1040ez form 2011 printable See Form W-7, Application for IRS Individual Taxpayer Identification Number. 1040ez form 2011 printable Also, see Social Security Numbers for Dependents , later. 1040ez form 2011 printable Photographs of missing children. 1040ez form 2011 printable   The Internal Revenue Service is a proud partner with the National Center for Missing and Exploited Children. 1040ez form 2011 printable Photographs of missing children selected by the Center may appear in this publication on pages that would otherwise be blank. 1040ez form 2011 printable You can help bring these children home by looking at the photographs and calling 1-800-THE-LOST (1-800-843-5678) if you recognize a child. 1040ez form 2011 printable Introduction This publication discusses some tax rules that affect every person who may have to file a federal income tax return. 1040ez form 2011 printable It answers some basic questions: who must file; who should file; what filing status to use; how many exemptions to claim; and the amount of the standard deduction. 1040ez form 2011 printable Who Must File explains who must file an income tax return. 1040ez form 2011 printable If you have little or no gross income, reading this section will help you decide if you have to file a return. 1040ez form 2011 printable Who Should File helps you decide if you should file a return, even if you are not required to do so. 1040ez form 2011 printable Filing Status helps you determine which filing status to use. 1040ez form 2011 printable Filing status is important in determining whether you must file a return and whether you may claim certain deductions and credits. 1040ez form 2011 printable It also helps determine your standard deduction and tax rate. 1040ez form 2011 printable Exemptions, which reduce your taxable income, are discussed in Exemptions . 1040ez form 2011 printable Exemptions for Dependents explains the difference between a qualifying child and a qualifying relative. 1040ez form 2011 printable Other topics include the social security number requirement for dependents, the rules for multiple support agreements, and the rules for divorced or separated parents. 1040ez form 2011 printable Phaseout of Exemptions explains how to determine whether you must reduce the dollar amount of exemptions you claim and, if so, the amount of the reduction. 1040ez form 2011 printable Standard Deduction gives the rules and dollar amounts for the standard deduction — a benefit for taxpayers who do not itemize their deductions. 1040ez form 2011 printable This section also discusses the standard deduction for taxpayers who are blind or age 65 or older, as well as special rules that limit the standard deduction available to dependents. 1040ez form 2011 printable In addition, this section helps you decide whether you would be better off taking the standard deduction or itemizing your deductions. 1040ez form 2011 printable How To Get Tax Help explains how to get tax help from the IRS. 1040ez form 2011 printable This publication is for U. 1040ez form 2011 printable S. 1040ez form 2011 printable citizens and resident aliens only. 1040ez form 2011 printable If you are a resident alien for the entire year, you must follow the same tax rules that apply to U. 1040ez form 2011 printable S. 1040ez form 2011 printable citizens. 1040ez form 2011 printable The rules to determine if you are a resident or nonresident alien are discussed in chapter 1 of Publication 519, U. 1040ez form 2011 printable S. 1040ez form 2011 printable Tax Guide for Aliens. 1040ez form 2011 printable Nonresident aliens. 1040ez form 2011 printable    If you were a nonresident alien at any time during the year, the rules and tax forms that apply to you may be different from those that apply to U. 1040ez form 2011 printable S. 1040ez form 2011 printable citizens. 1040ez form 2011 printable See Publication 519. 1040ez form 2011 printable Comments and suggestions. 1040ez form 2011 printable    We welcome your comments about this publication and your suggestions for future editions. 1040ez form 2011 printable   You can write to us at the following address: Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave. 1040ez form 2011 printable NW, IR-6526 Washington, DC 20224   We respond to many letters by telephone. 1040ez form 2011 printable Therefore, it would be helpful if you would include your daytime phone number, including the area code, in your correspondence. 1040ez form 2011 printable   You can send your comments from www. 1040ez form 2011 printable irs. 1040ez form 2011 printable gov/formspubs. 1040ez form 2011 printable Click on “More Information” and then on “Comment on Tax Forms and Publications. 1040ez form 2011 printable ”   Although we cannot respond individually to each comment received, we do appreciate your feedback and will consider your comments as we revise our tax products. 1040ez form 2011 printable Ordering forms and publications. 1040ez form 2011 printable    Visit www. 1040ez form 2011 printable irs. 1040ez form 2011 printable gov/formspubs to download forms and publications, call 1-800-TAX-FORM (1-800-829-3676), or write to the address below and receive a response within 10 days after your request is received. 1040ez form 2011 printable Internal Revenue Service 1201 N. 1040ez form 2011 printable Mitsubishi Motorway Bloomington, IL 61705-6613 Tax questions. 1040ez form 2011 printable    If you have a tax question, check the information available on IRS. 1040ez form 2011 printable gov or call 1-800-829-1040. 1040ez form 2011 printable We cannot answer tax questions sent to either of the above addresses. 1040ez form 2011 printable Useful Items - You may want to see: Publication 559 Survivors, Executors, and Administrators 929 Tax Rules for Children and Dependents Form (and Instructions) 1040X Amended U. 1040ez form 2011 printable S. 1040ez form 2011 printable Individual Income Tax Return 2848 Power of Attorney and Declaration of Representative 8332 Release/Revocation of Release of Claim to Exemption for Child by Custodial Parent 8814 Parents' Election To Report Child's Interest and Dividends Prev  Up  Next   Home   More Online Publications
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The 1040ez Form 2011 Printable

1040ez form 2011 printable Publication 969 - Main Content Table of Contents Health Savings Accounts (HSAs)Qualifying for an HSA Contributions to an HSA Distributions From an HSA Balance in an HSA Death of HSA Holder Filing Form 8889 Employer Participation Medical Savings Accounts (MSAs)Archer MSAs Contributions to an MSA Distributions From an MSA Balance in an Archer MSA Death of the Archer MSA Holder Filing Form 8853 Employer Participation Medicare Advantage MSAs Flexible Spending Arrangements (FSAs)Qualifying for an FSA Contributions to an FSA Distributions From an FSA Balance in an FSA Employer Participation Health Reimbursement Arrangements (HRAs)Qualifying for an HRA Contributions to an HRA Distributions From an HRA Balance in an HRA Employer Participation How To Get Tax HelpLow Income Taxpayer Clinics Health Savings Accounts (HSAs) A health savings account (HSA) is a tax-exempt trust or custodial account you set up with a qualified HSA trustee to pay or reimburse certain medical expenses you incur. 1040ez form 2011 printable You must be an eligible individual to qualify for an HSA. 1040ez form 2011 printable No permission or authorization from the IRS is necessary to establish an HSA. 1040ez form 2011 printable You set up an HSA with a trustee. 1040ez form 2011 printable A qualified HSA trustee can be a bank, an insurance company, or anyone already approved by the IRS to be a trustee of individual retirement arrangements (IRAs) or Archer MSAs. 1040ez form 2011 printable The HSA can be established through a trustee that is different from your health plan provider. 1040ez form 2011 printable Your employer may already have some information on HSA trustees in your area. 1040ez form 2011 printable If you have an Archer MSA, you can generally roll it over into an HSA tax free. 1040ez form 2011 printable See Rollovers, later. 1040ez form 2011 printable What are the benefits of an HSA?   You may enjoy several benefits from having an HSA. 1040ez form 2011 printable You can claim a tax deduction for contributions you, or someone other than your employer, make to your HSA even if you do not itemize your deductions on Form 1040. 1040ez form 2011 printable Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) may be excluded from your gross income. 1040ez form 2011 printable The contributions remain in your account until you use them. 1040ez form 2011 printable The interest or other earnings on the assets in the account are tax free. 1040ez form 2011 printable Distributions may be tax free if you pay qualified medical expenses. 1040ez form 2011 printable See Qualified medical expenses , later. 1040ez form 2011 printable An HSA is “portable. 1040ez form 2011 printable ” It stays with you if you change employers or leave the work force. 1040ez form 2011 printable Qualifying for an HSA To be an eligible individual and qualify for an HSA, you must meet the following requirements. 1040ez form 2011 printable You must be covered under a high deductible health plan (HDHP), described later, on the first day of the month. 1040ez form 2011 printable You have no other health coverage except what is permitted under Other health coverage , later. 1040ez form 2011 printable You are not enrolled in Medicare. 1040ez form 2011 printable You cannot be claimed as a dependent on someone else's 2013 tax return. 1040ez form 2011 printable Under the last-month rule, you are considered to be an eligible individual for the entire year if you are an eligible individual on the first day of the last month of your tax year (December 1 for most taxpayers). 1040ez form 2011 printable If you meet these requirements, you are an eligible individual even if your spouse has non-HDHP family coverage, provided your spouse's coverage does not cover you. 1040ez form 2011 printable If another taxpayer is entitled to claim an exemption for you, you cannot claim a deduction for an HSA contribution. 1040ez form 2011 printable This is true even if the other person does not actually claim your exemption. 1040ez form 2011 printable Each spouse who is an eligible individual who wants an HSA must open a separate HSA. 1040ez form 2011 printable You cannot have a joint HSA. 1040ez form 2011 printable High deductible health plan (HDHP). 1040ez form 2011 printable   An HDHP has: A higher annual deductible than typical health plans, and A maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that you must pay for covered expenses. 1040ez form 2011 printable Out-of-pocket expenses include copayments and other amounts, but do not include premiums. 1040ez form 2011 printable   An HDHP may provide preventive care benefits without a deductible or with a deductible less than the minimum annual deductible. 1040ez form 2011 printable Preventive care includes, but is not limited to, the following. 1040ez form 2011 printable Periodic health evaluations, including tests and diagnostic procedures ordered in connection with routine examinations, such as annual physicals. 1040ez form 2011 printable Routine prenatal and well-child care. 1040ez form 2011 printable Child and adult immunizations. 1040ez form 2011 printable Tobacco cessation programs. 1040ez form 2011 printable Obesity weight-loss programs. 1040ez form 2011 printable Screening services. 1040ez form 2011 printable This includes screening services for the following: Cancer. 1040ez form 2011 printable Heart and vascular diseases. 1040ez form 2011 printable Infectious diseases. 1040ez form 2011 printable Mental health conditions. 1040ez form 2011 printable Substance abuse. 1040ez form 2011 printable Metabolic, nutritional, and endocrine conditions. 1040ez form 2011 printable Musculoskeletal disorders. 1040ez form 2011 printable Obstetric and gynecological conditions. 1040ez form 2011 printable Pediatric conditions. 1040ez form 2011 printable Vision and hearing disorders. 1040ez form 2011 printable For more information on screening services, see Notice 2004-23, 2004-15 I. 1040ez form 2011 printable R. 1040ez form 2011 printable B. 1040ez form 2011 printable 725 available at www. 1040ez form 2011 printable irs. 1040ez form 2011 printable gov/irb/2004-15_IRB/ar10. 1040ez form 2011 printable html. 1040ez form 2011 printable     The following table shows the minimum annual deductible and maximum annual deductible and other out-of-pocket expenses for HDHPs for 2013. 1040ez form 2011 printable      Self-only coverage Family coverage Minimum annual deductible $1,250 $2,500 Maximum annual deductible and other out-of-pocket expenses* $6,250 $12,500 * This limit does not apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. 1040ez form 2011 printable Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit applies. 1040ez form 2011 printable    The following table shows the minimum annual deductible and maximum annual deductible and other out-of-pocket expenses for HDHPs for 2014. 1040ez form 2011 printable      Self-only coverage Family coverage Minimum annual deductible $1,250 $2,500 Maximum annual deductible and other out-of-pocket expenses* $6,350 $12,700 * This limit does not apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. 1040ez form 2011 printable Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit applies. 1040ez form 2011 printable   Self-only HDHP coverage is an HDHP covering only an eligible individual. 1040ez form 2011 printable Family HDHP coverage is an HDHP covering an eligible individual and at least one other individual (whether or not that individual is an eligible individual). 1040ez form 2011 printable Example. 1040ez form 2011 printable An eligible individual and his dependent child are covered under an “employee plus one” HDHP offered by the individual's employer. 1040ez form 2011 printable This is family HDHP coverage. 1040ez form 2011 printable Family plans that do not meet the high deductible rules. 1040ez form 2011 printable   There are some family plans that have deductibles for both the family as a whole and for individual family members. 1040ez form 2011 printable Under these plans, if you meet the individual deductible for one family member, you do not have to meet the higher annual deductible amount for the family. 1040ez form 2011 printable If either the deductible for the family as a whole or the deductible for an individual family member is less than the minimum annual deductible for family coverage, the plan does not qualify as an HDHP. 1040ez form 2011 printable Example. 1040ez form 2011 printable You have family health insurance coverage in 2013. 1040ez form 2011 printable The annual deductible for the family plan is $3,500. 1040ez form 2011 printable This plan also has an individual deductible of $1,500 for each family member. 1040ez form 2011 printable The plan does not qualify as an HDHP because the deductible for an individual family member is less than the minimum annual deductible ($2,500) for family coverage. 1040ez form 2011 printable Other health coverage. 1040ez form 2011 printable   You (and your spouse, if you have family coverage) generally cannot have any other health coverage that is not an HDHP. 1040ez form 2011 printable However, you can still be an eligible individual even if your spouse has non-HDHP coverage provided you are not covered by that plan. 1040ez form 2011 printable    You can have additional insurance that provides benefits only for the following items. 1040ez form 2011 printable Liabilities incurred under workers' compensation laws, tort liabilities, or liabilities related to ownership or use of property. 1040ez form 2011 printable A specific disease or illness. 1040ez form 2011 printable A fixed amount per day (or other period) of hospitalization. 1040ez form 2011 printable   You can also have coverage (whether provided through insurance or otherwise) for the following items. 1040ez form 2011 printable Accidents. 1040ez form 2011 printable Disability. 1040ez form 2011 printable Dental care. 1040ez form 2011 printable Vision care. 1040ez form 2011 printable Long-term care. 1040ez form 2011 printable    Plans in which substantially all of the coverage is through the items listed earlier are not HDHPs. 1040ez form 2011 printable For example, if your plan provides coverage substantially all of which is for a specific disease or illness, the plan is not an HDHP for purposes of establishing an HSA. 1040ez form 2011 printable Prescription drug plans. 1040ez form 2011 printable   You can have a prescription drug plan, either as part of your HDHP or a separate plan (or rider), and qualify as an eligible individual if the plan does not provide benefits until the minimum annual deductible of the HDHP has been met. 1040ez form 2011 printable If you can receive benefits before that deductible is met, you are not an eligible individual. 1040ez form 2011 printable Other employee health plans. 1040ez form 2011 printable   An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses generally cannot make contributions to an HSA. 1040ez form 2011 printable Health FSAs and HRAs are discussed later. 1040ez form 2011 printable   However, an employee can make contributions to an HSA while covered under an HDHP and one or more of the following arrangements. 1040ez form 2011 printable Limited-purpose health FSA or HRA. 1040ez form 2011 printable These arrangements can pay or reimburse the items listed earlier under Other health coverage except long-term care. 1040ez form 2011 printable Also, these arrangements can pay or reimburse preventive care expenses because they can be paid without having to satisfy the deductible. 1040ez form 2011 printable Suspended HRA. 1040ez form 2011 printable Before the beginning of an HRA coverage period, you can elect to suspend the HRA. 1040ez form 2011 printable The HRA does not pay or reimburse, at any time, the medical expenses incurred during the suspension period except preventive care and items listed under Other health coverage. 1040ez form 2011 printable When the suspension period ends, you are no longer eligible to make contributions to an HSA. 1040ez form 2011 printable Post-deductible health FSA or HRA. 1040ez form 2011 printable These arrangements do not pay or reimburse any medical expenses incurred before the minimum annual deductible amount is met. 1040ez form 2011 printable The deductible for these arrangements does not have to be the same as the deductible for the HDHP, but benefits may not be provided before the minimum annual deductible amount is met. 1040ez form 2011 printable Retirement HRA. 1040ez form 2011 printable This arrangement pays or reimburses only those medical expenses incurred after retirement. 1040ez form 2011 printable After retirement you are no longer eligible to make contributions to an HSA. 1040ez form 2011 printable Health FSA – grace period. 1040ez form 2011 printable   Coverage during a grace period by a general purpose health FSA is allowed if the balance in the health FSA at the end of its prior year plan is zero. 1040ez form 2011 printable See Flexible Spending Arrangements (FSAs) , later. 1040ez form 2011 printable Contributions to an HSA Any eligible individual can contribute to an HSA. 1040ez form 2011 printable For an employee's HSA, the employee, the employee's employer, or both may contribute to the employee's HSA in the same year. 1040ez form 2011 printable For an HSA established by a self-employed (or unemployed) individual, the individual can contribute. 1040ez form 2011 printable Family members or any other person may also make contributions on behalf of an eligible individual. 1040ez form 2011 printable Contributions to an HSA must be made in cash. 1040ez form 2011 printable Contributions of stock or property are not allowed. 1040ez form 2011 printable Limit on Contributions The amount you or any other person can contribute to your HSA depends on the type of HDHP coverage you have, your age, the date you become an eligible individual, and the date you cease to be an eligible individual. 1040ez form 2011 printable For 2013, if you have self-only HDHP coverage, you can contribute up to $3,250. 1040ez form 2011 printable If you have family HDHP coverage, you can contribute up to $6,450. 1040ez form 2011 printable For 2014, if you have self-only HDHP coverage, you can contribute up to $3,300. 1040ez form 2011 printable If you have family HDHP coverage you can contribute up to $6,550. 1040ez form 2011 printable If you were, or were considered (under the last-month rule, discussed later), an eligible individual for the entire year and did not change your type of coverage, you can contribute the full amount based on your type of coverage. 1040ez form 2011 printable However, if you were not an eligible individual for the entire year or changed your coverage during the year, your contribution limit is the greater of: The limitation shown on the Line 3 Limitation Chart and Worksheetin the Instructions for Form 8889, Health Savings Accounts (HSAs), or The maximum annual HSA contribution based on your HDHP coverage (self-only or family) on the first day of the last month of your tax year. 1040ez form 2011 printable If you had family HDHP coverage on the first day of the last month of your tax year, your contribution limit for 2013 is $6,450 even if you changed coverage during the year. 1040ez form 2011 printable Last-month rule. 1040ez form 2011 printable   Under the last-month rule, if you are an eligible individual on the first day of the last month of your tax year (December 1 for most taxpayers), you are considered an eligible individual for the entire year. 1040ez form 2011 printable You are treated as having the same HDHP coverage for the entire year as you had on the first day of the last month. 1040ez form 2011 printable Testing period. 1040ez form 2011 printable   If contributions were made to your HSA based on you being an eligible individual for the entire year under the last-month rule, you must remain an eligible individual during the testing period. 1040ez form 2011 printable For the last-month rule, the testing period begins with the last month of your tax year and ends on the last day of the 12th month following that month. 1040ez form 2011 printable For example, December 1, 2013, through December 31, 2014. 1040ez form 2011 printable   If you fail to remain an eligible individual during the testing period, other than because of death or becoming disabled, you will have to include in income the total contributions made to your HSA that would not have been made except for the last-month rule. 1040ez form 2011 printable You include this amount in your income in the year in which you fail to be an eligible individual. 1040ez form 2011 printable This amount is also subject to a 10% additional tax. 1040ez form 2011 printable The income and additional tax are shown on Form 8889, Part III. 1040ez form 2011 printable Example 1. 1040ez form 2011 printable Chris, age 53, becomes an eligible individual on December 1, 2013. 1040ez form 2011 printable He has family HDHP coverage on that date. 1040ez form 2011 printable Under the last-month rule, he contributes $6,450 to his HSA. 1040ez form 2011 printable Chris fails to be an eligible individual in June 2014. 1040ez form 2011 printable Because Chris did not remain an eligible individual during the testing period (December 1, 2013, through December 31, 2014), he must include in his 2014 income the contributions made in 2013 that would not have been made except for the last-month rule. 1040ez form 2011 printable Chris uses the worksheet in the Form 8889 instructions to determine this amount. 1040ez form 2011 printable January -0- February -0- March -0- April -0- May -0- June -0- July -0- August -0- September -0- October -0- November -0- December $6,450. 1040ez form 2011 printable 00 Total for all months $6,450. 1040ez form 2011 printable 00 Limitation. 1040ez form 2011 printable Divide the total by 12 $537. 1040ez form 2011 printable 50 Chris would include $5,912. 1040ez form 2011 printable 50 ($6,450. 1040ez form 2011 printable 00 – $537. 1040ez form 2011 printable 50) in his gross income on his 2014 tax return. 1040ez form 2011 printable Also, a 10% additional tax applies to this amount. 1040ez form 2011 printable Example 2. 1040ez form 2011 printable Erika, age 39, has self-only HDHP coverage on January 1, 2013. 1040ez form 2011 printable Erika changes to family HDHP coverage on November 1, 2013. 1040ez form 2011 printable Because Erika has family HDHP coverage on December 1, 2013, she contributes $6,450 for 2013. 1040ez form 2011 printable Erika fails to be an eligible individual in March 2014. 1040ez form 2011 printable Because she did not remain an eligible individual during the testing period (December 1, 2013, through December 31, 2014), she must include in income the contribution made that would not have been made except for the last-month rule. 1040ez form 2011 printable Erika uses the worksheet in the Form 8889 instructions to determine this amount. 1040ez form 2011 printable January $3,250. 1040ez form 2011 printable 00 February $3,250. 1040ez form 2011 printable 00 March $3,250. 1040ez form 2011 printable 00 April $3,250. 1040ez form 2011 printable 00 May $3,250. 1040ez form 2011 printable 00 June $3,250. 1040ez form 2011 printable 00 July $3,250. 1040ez form 2011 printable 00 August $3,250. 1040ez form 2011 printable 00 September $3,250. 1040ez form 2011 printable 00 October $3,250. 1040ez form 2011 printable 00 November $6,450. 1040ez form 2011 printable 00 December $6,450. 1040ez form 2011 printable 00 Total for all months $45,400. 1040ez form 2011 printable 00 Limitation. 1040ez form 2011 printable Divide the total by 12 $3,783. 1040ez form 2011 printable 34 Erika would include $2,666. 1040ez form 2011 printable 67 ($6,450 – $3,783. 1040ez form 2011 printable 34) in her gross income on her 2014 tax return. 1040ez form 2011 printable Also, a 10% additional tax applies to this amount. 1040ez form 2011 printable Additional contribution. 1040ez form 2011 printable   If you are an eligible individual who is age 55 or older at the end of your tax year, your contribution limit is increased by $1,000. 1040ez form 2011 printable For example, if you have self-only coverage, you can contribute up to $4,250 (the contribution limit for self-only coverage ($3,250) plus the additional contribution of $1,000). 1040ez form 2011 printable However, see Enrolled in Medicare , later. 1040ez form 2011 printable If you have more than one HSA in 2013, your total contributions to all the HSAs cannot be more than the limits discussed earlier. 1040ez form 2011 printable Reduction of contribution limit. 1040ez form 2011 printable   You must reduce the amount that can be contributed (including any additional contribution) to your HSA by the amount of any contribution made to your Archer MSA (including employer contributions) for the year. 1040ez form 2011 printable A special rule applies to married people, discussed next, if each spouse has family coverage under an HDHP. 1040ez form 2011 printable Rules for married people. 1040ez form 2011 printable   If either spouse has family HDHP coverage, both spouses are treated as having family HDHP coverage. 1040ez form 2011 printable If each spouse has family coverage under a separate plan, the contribution limit for 2013 is $6,450. 1040ez form 2011 printable You must reduce the limit on contributions, before taking into account any additional contributions, by the amount contributed to both spouses' Archer MSAs. 1040ez form 2011 printable After that reduction, the contribution limit is split equally between the spouses unless you agree on a different division. 1040ez form 2011 printable The rules for married people apply only if both spouses are eligible individuals. 1040ez form 2011 printable If both spouses are 55 or older and not enrolled in Medicare, each spouse's contribution limit is increased by the additional contribution. 1040ez form 2011 printable If both spouses meet the age requirement, the total contributions under family coverage cannot be more than $8,450. 1040ez form 2011 printable Each spouse must make the additional contribution to his or her own HSA. 1040ez form 2011 printable Example. 1040ez form 2011 printable For 2013, Mr. 1040ez form 2011 printable Auburn and his wife are both eligible individuals. 1040ez form 2011 printable They each have family coverage under separate HDHPs. 1040ez form 2011 printable Mr. 1040ez form 2011 printable Auburn is 58 years old and Mrs. 1040ez form 2011 printable Auburn is 53. 1040ez form 2011 printable Mr. 1040ez form 2011 printable and Mrs. 1040ez form 2011 printable Auburn can split the family contribution limit ($6,450) equally or they can agree on a different division. 1040ez form 2011 printable If they split it equally, Mr. 1040ez form 2011 printable Auburn can contribute $4,225 to an HSA (one-half the maximum contribution for family coverage ($3,225) + $1,000 additional contribution) and Mrs. 1040ez form 2011 printable Auburn can contribute $3,225 to an HSA. 1040ez form 2011 printable Employer contributions. 1040ez form 2011 printable   You must reduce the amount you, or any other person, can contribute to your HSA by the amount of any contributions made by your employer that are excludable from your income. 1040ez form 2011 printable This includes amounts contributed to your account by your employer through a cafeteria plan. 1040ez form 2011 printable Enrolled in Medicare. 1040ez form 2011 printable   Beginning with the first month you are enrolled in Medicare, your contribution limit is zero. 1040ez form 2011 printable Example. 1040ez form 2011 printable You turned age 65 in July 2013 and enrolled in Medicare. 1040ez form 2011 printable You had an HDHP with self-only coverage and are eligible for an additional contribution of $1,000. 1040ez form 2011 printable Your contribution limit is $2,125 ($4,250 × 6 ÷ 12). 1040ez form 2011 printable Qualified HSA funding distribution. 1040ez form 2011 printable   A qualified HSA funding distribution may be made from your traditional IRA or Roth IRA to your HSA. 1040ez form 2011 printable This distribution cannot be made from an ongoing SEP IRA or SIMPLE IRA. 1040ez form 2011 printable For this purpose, a SEP IRA or SIMPLE IRA is ongoing if an employer contribution is made for the plan year ending with or within your tax year in which the distribution would be made. 1040ez form 2011 printable   The maximum qualified HSA funding distribution depends on the HDHP coverage (self-only or family) you have on the first day of the month in which the contribution is made and your age as of the end of the tax year. 1040ez form 2011 printable The distribution must be made directly by the trustee of the IRA to the trustee of the HSA. 1040ez form 2011 printable The distribution is not included in your income, is not deductible, and reduces the amount that can be contributed to your HSA. 1040ez form 2011 printable The qualified HSA funding distribution is shown on Form 8889 for the year in which the distribution is made. 1040ez form 2011 printable   You can make only one qualified HSA funding distribution during your lifetime. 1040ez form 2011 printable However, if you make a distribution during a month when you have self-only HDHP coverage, you can make another qualified HSA funding distribution in a later month in that tax year if you change to family HDHP coverage. 1040ez form 2011 printable The total qualified HSA funding distribution cannot be more than the contribution limit for family HDHP coverage plus any additional contribution to which you are entitled. 1040ez form 2011 printable Example. 1040ez form 2011 printable In 2013, you are an eligible individual, age 57, with self-only HDHP coverage. 1040ez form 2011 printable You can make a qualified HSA funding distribution of $4,250 ($3,250 plus $1,000 additional contribution). 1040ez form 2011 printable Funding distribution – testing period. 1040ez form 2011 printable   You must remain an eligible individual during the testing period. 1040ez form 2011 printable For a qualified HSA funding distribution, the testing period begins with the month in which the qualified HSA funding distribution is contributed and ends on the last day of the 12th month following that month. 1040ez form 2011 printable For example, if a qualified HSA funding distribution is contributed to your HSA on August 10, 2013, your testing period begins in August 2013, and ends on August 31, 2014. 1040ez form 2011 printable   If you fail to remain an eligible individual during the testing period, other than because of death or becoming disabled, you will have to include in income the qualified HSA funding distribution. 1040ez form 2011 printable You include this amount in income in the year in which you fail to be an eligible individual. 1040ez form 2011 printable This amount is also subject to a 10% additional tax. 1040ez form 2011 printable The income and the additional tax are shown on Form 8889, Part III. 1040ez form 2011 printable   Each qualified HSA funding distribution allowed has its own testing period. 1040ez form 2011 printable For example, you are an eligible individual, age 45, with self-only HDHP coverage. 1040ez form 2011 printable On June 18, 2013, you make a qualified HSA funding distribution of $3,250. 1040ez form 2011 printable On July 27, 2013, you enroll in family HDHP coverage and on August 17, 2013, you make a qualified HSA funding distribution of $3,200. 1040ez form 2011 printable Your testing period for the first distribution begins in June 2013 and ends on June 30, 2014. 1040ez form 2011 printable Your testing period for the second distribution begins in August 2013 and ends on August 31, 2014. 1040ez form 2011 printable   The testing period rule that applies under the last-month rule (discussed earlier) does not apply to amounts contributed to an HSA through a qualified HSA funding distribution. 1040ez form 2011 printable If you remain an eligible individual during the entire funding distribution testing period, then no amount of that distribution is included in income and will not be subject to the additional tax for failing to meet the last-month rule testing period. 1040ez form 2011 printable Rollovers A rollover contribution is not included in your income, is not deductible, and does not reduce your contribution limit. 1040ez form 2011 printable Archer MSAs and other HSAs. 1040ez form 2011 printable   You can roll over amounts from Archer MSAs and other HSAs into an HSA. 1040ez form 2011 printable You do not have to be an eligible individual to make a rollover contribution from your existing HSA to a new HSA. 1040ez form 2011 printable Rollover contributions do not need to be in cash. 1040ez form 2011 printable Rollovers are not subject to the annual contribution limits. 1040ez form 2011 printable   You must roll over the amount within 60 days after the date of receipt. 1040ez form 2011 printable You can make only one rollover contribution to an HSA during a 1-year period. 1040ez form 2011 printable Note. 1040ez form 2011 printable If you instruct the trustee of your HSA to transfer funds directly to the trustee of another of your HSAs, the transfer is not considered a rollover. 1040ez form 2011 printable There is no limit on the number of these transfers. 1040ez form 2011 printable Do not include the amount transferred in income, deduct it as a contribution, or include it as a distribution on Form 8889. 1040ez form 2011 printable When To Contribute You can make contributions to your HSA for 2013 until April 15, 2014. 1040ez form 2011 printable If you fail to be an eligible individual during 2013, you can still make contributions, up until April 15, 2014, for the months you were an eligible individual. 1040ez form 2011 printable Your employer can make contributions to your HSA between January 1, 2014, and April 15, 2014, that are allocated to 2013. 1040ez form 2011 printable Your employer must notify you and the trustee of your HSA that the contribution is for 2013. 1040ez form 2011 printable The contribution will be reported on your 2014 Form W-2. 1040ez form 2011 printable Reporting Contributions on Your Return Contributions made by your employer are not included in your income. 1040ez form 2011 printable Contributions to an employee's account by an employer using the amount of an employee's salary reduction through a cafeteria plan are treated as employer contributions. 1040ez form 2011 printable Generally, you can claim contributions you made and contributions made by any other person, other than your employer, on your behalf, as an adjustment to income. 1040ez form 2011 printable Contributions by a partnership to a bona fide partner's HSA are not contributions by an employer. 1040ez form 2011 printable The contributions are treated as a distribution of money and are not included in the partner's gross income. 1040ez form 2011 printable Contributions by a partnership to a partner's HSA for services rendered are treated as guaranteed payments that are deductible by the partnership and includible in the partner's gross income. 1040ez form 2011 printable In both situations, the partner can deduct the contribution made to the partner's HSA. 1040ez form 2011 printable Contributions by an S corporation to a 2% shareholder-employee's HSA for services rendered are treated as guaranteed payments and are deductible by the S corporation and includible in the shareholder-employee's gross income. 1040ez form 2011 printable The shareholder-employee can deduct the contribution made to the shareholder-employee's HSA. 1040ez form 2011 printable Form 8889. 1040ez form 2011 printable   Report all contributions to your HSA on Form 8889 and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable You should include all contributions made for 2013, including those made by April 15, 2014, that are designated for 2013. 1040ez form 2011 printable Contributions made by your employer and qualified HSA funding distributions are also shown on the form. 1040ez form 2011 printable   You should receive Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information, from the trustee showing the amount contributed to your HSA during the year. 1040ez form 2011 printable Your employer's contributions also will be shown in box 12 of Form W-2, Wage and Tax Statement, with code W. 1040ez form 2011 printable Follow the instructions for Form 8889. 1040ez form 2011 printable Report your HSA deduction on Form 1040 or Form 1040NR. 1040ez form 2011 printable Excess contributions. 1040ez form 2011 printable   You will have excess contributions if the contributions to your HSA for the year are greater than the limits discussed earlier. 1040ez form 2011 printable Excess contributions are not deductible. 1040ez form 2011 printable Excess contributions made by your employer are included in your gross income. 1040ez form 2011 printable If the excess contribution is not included in box 1 of Form W-2, you must report the excess as “Other income” on your tax return. 1040ez form 2011 printable   Generally, you must pay a 6% excise tax on excess contributions. 1040ez form 2011 printable See Form 5329, Additional Taxes on Qualified Plans (including IRAs) and Other Tax-Favored Accounts, to figure the excise tax. 1040ez form 2011 printable The excise tax applies to each tax year the excess contribution remains in the account. 1040ez form 2011 printable   You may withdraw some or all of the excess contributions and not pay the excise tax on the amount withdrawn if you meet the following conditions. 1040ez form 2011 printable You withdraw the excess contributions by the due date, including extensions, of your tax return for the year the contributions were made. 1040ez form 2011 printable You withdraw any income earned on the withdrawn contributions and include the earnings in “Other income” on your tax return for the year you withdraw the contributions and earnings. 1040ez form 2011 printable If you fail to remain an eligible individual during any of the testing periods, discussed earlier, the amount you have to include in income is not an excess contribution. 1040ez form 2011 printable If you withdraw any of those amounts, the amount is treated the same as any other distribution from an HSA, discussed later. 1040ez form 2011 printable Deducting an excess contribution in a later year. 1040ez form 2011 printable   You may be able to deduct excess contributions for previous years that are still in your HSA. 1040ez form 2011 printable The excess contribution you can deduct for the current year is the lesser of the following two amounts. 1040ez form 2011 printable Your maximum HSA contribution limit for the year minus any amounts contributed to your HSA for the year. 1040ez form 2011 printable The total excess contributions in your HSA at the beginning of the year. 1040ez form 2011 printable   Amounts contributed for the year include contributions by you, your employer, and any other person. 1040ez form 2011 printable They also include any qualified HSA funding distribution made to your HSA. 1040ez form 2011 printable Any excess contribution remaining at the end of a tax year is subject to the excise tax. 1040ez form 2011 printable See Form 5329. 1040ez form 2011 printable Distributions From an HSA You will generally pay medical expenses during the year without being reimbursed by your HDHP until you reach the annual deductible for the plan. 1040ez form 2011 printable When you pay medical expenses during the year that are not reimbursed by your HDHP, you can ask the trustee of your HSA to send you a distribution from your HSA. 1040ez form 2011 printable You can receive tax-free distributions from your HSA to pay or be reimbursed for qualified medical expenses you incur after you establish the HSA. 1040ez form 2011 printable If you receive distributions for other reasons, the amount you withdraw will be subject to income tax and may be subject to an additional 20% tax. 1040ez form 2011 printable You do not have to make distributions from your HSA each year. 1040ez form 2011 printable If you are no longer an eligible individual, you can still receive tax-free distributions to pay or reimburse your qualified medical expenses. 1040ez form 2011 printable Generally, a distribution is money you get from your health savings account. 1040ez form 2011 printable Your total distributions include amounts paid with a debit card that restricts payments to health care and amounts withdrawn from the HSA by other individuals that you have designated. 1040ez form 2011 printable The trustee will report any distribution to you and the IRS on Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA. 1040ez form 2011 printable Qualified medical expenses. 1040ez form 2011 printable   Qualified medical expenses are those expenses that would generally qualify for the medical and dental expenses deduction. 1040ez form 2011 printable These are explained in Publication 502, Medical and Dental Expenses. 1040ez form 2011 printable   Also, non-prescription medicines (other than insulin) are not considered qualified medical expenses for HSA purposes. 1040ez form 2011 printable A medicine or drug will be a qualified medical expense for HSA purposes only if the medicine or drug: Requires a prescription, Is available without a prescription (an over-the-counter medicine or drug) and you get a prescription for it, or Is insulin. 1040ez form 2011 printable   For HSA purposes, expenses incurred before you establish your HSA are not qualified medical expenses. 1040ez form 2011 printable State law determines when an HSA is established. 1040ez form 2011 printable An HSA that is funded by amounts rolled over from an Archer MSA or another HSA is established on the date the prior account was established. 1040ez form 2011 printable   If, under the last-month rule, you are considered to be an eligible individual for the entire year for determining the contribution amount, only those expenses incurred after you actually establish your HSA are qualified medical expenses. 1040ez form 2011 printable   Qualified medical expenses are those incurred by the following persons. 1040ez form 2011 printable You and your spouse. 1040ez form 2011 printable All dependents you claim on your tax return. 1040ez form 2011 printable Any person you could have claimed as a dependent on your return except that: The person filed a joint return, The person had gross income of $3,900 or more, or You, or your spouse if filing jointly, could be claimed as a dependent on someone else's 2013 return. 1040ez form 2011 printable    For this purpose, a child of parents that are divorced, separated, or living apart for the last 6 months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child's exemption. 1040ez form 2011 printable You cannot deduct qualified medical expenses as an itemized deduction on Schedule A (Form 1040) that are equal to the tax-free distribution from your HSA. 1040ez form 2011 printable Insurance premiums. 1040ez form 2011 printable   You cannot treat insurance premiums as qualified medical expenses unless the premiums are for: Long-term care insurance. 1040ez form 2011 printable Health care continuation coverage (such as coverage under COBRA). 1040ez form 2011 printable Health care coverage while receiving unemployment compensation under federal or state law. 1040ez form 2011 printable Medicare and other health care coverage if you were 65 or older (other than premiums for a Medicare supplemental policy, such as Medigap). 1040ez form 2011 printable   The premiums for long-term care insurance (item (1)) that you can treat as qualified medical expenses are subject to limits based on age and are adjusted annually. 1040ez form 2011 printable See Limit on long-term care premiums you can deduct in the instructions for Schedule A (Form 1040). 1040ez form 2011 printable   Items (2) and (3) can be for your spouse or a dependent meeting the requirement for that type of coverage. 1040ez form 2011 printable For item (4), if you, the account beneficiary, are not 65 or older, Medicare premiums for coverage of your spouse or a dependent (who is 65 or older) generally are not qualified medical expenses. 1040ez form 2011 printable Health coverage tax credit. 1040ez form 2011 printable   You cannot claim this credit for premiums that you pay with a tax-free distribution from your HSA. 1040ez form 2011 printable See Publication 502 for more information on this credit. 1040ez form 2011 printable Deemed distributions from HSAs. 1040ez form 2011 printable   The following situations result in deemed taxable distributions from your HSA. 1040ez form 2011 printable You engaged in any transaction prohibited by section 4975 with respect to any of your HSAs, at any time in 2013. 1040ez form 2011 printable Your account ceases to be an HSA as of January 1, 2013, and you must include the fair market value of all assets in the account as of January 1, 2013, on Form 8889. 1040ez form 2011 printable You used any portion of any of your HSAs as security for a loan at any time in 2013. 1040ez form 2011 printable You must include the fair market value of the assets used as security for the loan as income on Form 1040 or Form 1040NR. 1040ez form 2011 printable   Examples of prohibited transactions include the direct or indirect: Sale, exchange, or leasing of property between you and the HSA, Lending of money between you and the HSA, Furnishing goods, services, or facilities between you and the HSA, and Transfer to or use by you, or for your benefit, of any assets of the HSA. 1040ez form 2011 printable   Any deemed distribution will not be treated as used to pay qualified medical expenses. 1040ez form 2011 printable These distributions are included in your income and are subject to the additional 20% tax, discussed later. 1040ez form 2011 printable Recordkeeping. 1040ez form 2011 printable You must keep records sufficient to show that: The distributions were exclusively to pay or reimburse qualified medical expenses, The qualified medical expenses had not been previously paid or reimbursed from another source, and The medical expenses had not been taken as an itemized deduction in any year. 1040ez form 2011 printable Do not send these records with your tax return. 1040ez form 2011 printable Keep them with your tax records. 1040ez form 2011 printable Reporting Distributions on Your Return How you report your distributions depends on whether or not you use the distribution for qualified medical expenses (defined earlier). 1040ez form 2011 printable If you use a distribution from your HSA for qualified medical expenses, you do not pay tax on the distribution but you have to report the distribution on Form 8889. 1040ez form 2011 printable However, the distribution of an excess contribution taken out after the due date, including extensions, of your return is subject to tax even if used for qualified medical expenses. 1040ez form 2011 printable Follow the instructions for the form and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable If you do not use a distribution from your HSA for qualified medical expenses, you must pay tax on the distribution. 1040ez form 2011 printable Report the amount on Form 8889 and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable You may have to pay an additional 20% tax on your taxable distribution. 1040ez form 2011 printable HSA administration and maintenance fees withdrawn by the trustee are not reported as distributions from the HSA. 1040ez form 2011 printable Additional tax. 1040ez form 2011 printable   There is an additional 20% tax on the part of your distributions not used for qualified medical expenses. 1040ez form 2011 printable Figure the tax on Form 8889 and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable Exceptions. 1040ez form 2011 printable   There is no additional tax on distributions made after the date you are disabled, reach age 65, or die. 1040ez form 2011 printable Balance in an HSA An HSA is generally exempt from tax. 1040ez form 2011 printable You are permitted to take a distribution from your HSA at any time; however, only those amounts used exclusively to pay for qualified medical expenses are tax free. 1040ez form 2011 printable Amounts that remain at the end of the year are generally carried over to the next year (see Excess contributions , earlier). 1040ez form 2011 printable Earnings on amounts in an HSA are not included in your income while held in the HSA. 1040ez form 2011 printable Death of HSA Holder You should choose a beneficiary when you set up your HSA. 1040ez form 2011 printable What happens to that HSA when you die depends on whom you designate as the beneficiary. 1040ez form 2011 printable Spouse is the designated beneficiary. 1040ez form 2011 printable   If your spouse is the designated beneficiary of your HSA, it will be treated as your spouse's HSA after your death. 1040ez form 2011 printable Spouse is not the designated beneficiary. 1040ez form 2011 printable   If your spouse is not the designated beneficiary of your HSA: The account stops being an HSA, and The fair market value of the HSA becomes taxable to the beneficiary in the year in which you die. 1040ez form 2011 printable If your estate is the beneficiary, the value is included on your final income tax return. 1040ez form 2011 printable The amount taxable to a beneficiary other than the estate is reduced by any qualified medical expenses for the decedent that are paid by the beneficiary within 1 year after the date of death. 1040ez form 2011 printable Filing Form 8889 You must file Form 8889 with your Form 1040 or Form 1040NR if you (or your spouse, if married filing a joint return) had any activity in your HSA during the year. 1040ez form 2011 printable You must file the form even if only your employer or your spouse's employer made contributions to the HSA. 1040ez form 2011 printable If, during the tax year, you are the beneficiary of two or more HSAs or you are a beneficiary of an HSA and you have your own HSA, you must complete a separate Form 8889 for each HSA. 1040ez form 2011 printable Enter “statement” at the top of each Form 8889 and complete the form as instructed. 1040ez form 2011 printable Next, complete a controlling Form 8889 combining the amounts shown on each of the statement Forms 8889. 1040ez form 2011 printable Attach the statements to your tax return after the controlling Form 8889. 1040ez form 2011 printable Employer Participation This section contains the rules that employers must follow if they decide to make HSAs available to their employees. 1040ez form 2011 printable Unlike the previous discussions, “you” refers to the employer and not to the employee. 1040ez form 2011 printable Health plan. 1040ez form 2011 printable   If you want your employees to be able to have an HSA, they must have an HDHP. 1040ez form 2011 printable You can provide no additional coverage other than those exceptions listed previously under Other health coverage . 1040ez form 2011 printable Contributions. 1040ez form 2011 printable   You can make contributions to your employees' HSAs. 1040ez form 2011 printable You deduct the contributions on your business income tax return for the year in which you make the contributions. 1040ez form 2011 printable If the contribution is allocated to the prior year, you still deduct it in the year in which you made the contribution. 1040ez form 2011 printable   For more information on employer contributions, see Notice 2008-59, 2008-29 I. 1040ez form 2011 printable R. 1040ez form 2011 printable B. 1040ez form 2011 printable 123, questions 23 through 27, available at www. 1040ez form 2011 printable irs. 1040ez form 2011 printable gov/irb/2008-29_IRB/ar11. 1040ez form 2011 printable html. 1040ez form 2011 printable Comparable contributions. 1040ez form 2011 printable   If you decide to make contributions, you must make comparable contributions to all comparable participating employees' HSAs. 1040ez form 2011 printable Your contributions are comparable if they are either: The same amount, or The same percentage of the annual deductible limit under the HDHP covering the employees. 1040ez form 2011 printable The comparability rules do not apply to contributions made through a cafeteria plan. 1040ez form 2011 printable Comparable participating employees. 1040ez form 2011 printable   Comparable participating employees: Are covered by your HDHP and are eligible to establish an HSA, Have the same category of coverage (either self-only or family coverage), and Have the same category of employment (part-time, full-time, or former employees). 1040ez form 2011 printable   To meet the comparability requirements for eligible employees who have not established an HSA by December 31 or have not notified you that they have an HSA, you must meet a notice requirement and a contribution requirement. 1040ez form 2011 printable   You will meet the notice requirement if by January 15 of the following calendar year you provide a written notice to all such employees. 1040ez form 2011 printable The notice must state that each eligible employee who, by the last day of February, establishes an HSA and notifies you that they have established an HSA will receive a comparable contribution to the HSA for the prior year. 1040ez form 2011 printable For a sample of the notice, see Regulation 54. 1040ez form 2011 printable 4980G-4 A-14(c). 1040ez form 2011 printable You will meet the contribution requirement for these employees if by April 15, 2014, you contribute comparable amounts plus reasonable interest to the employee's HSA for the prior year. 1040ez form 2011 printable Note. 1040ez form 2011 printable For purposes of making contributions to HSAs of non-highly compensated employees, highly compensated employees shall not be treated as comparable participating employees. 1040ez form 2011 printable Excise tax. 1040ez form 2011 printable   If you made contributions to your employees' HSAs that were not comparable, you must pay an excise tax of 35% of the amount you contributed. 1040ez form 2011 printable Employment taxes. 1040ez form 2011 printable   Amounts you contribute to your employees' HSAs are generally not subject to employment taxes. 1040ez form 2011 printable You must report the contributions in box 12 of the Form W-2 you file for each employee. 1040ez form 2011 printable This includes the amounts the employee elected to contribute through a cafeteria plan. 1040ez form 2011 printable Enter code “W” in box 12. 1040ez form 2011 printable Medical Savings Accounts (MSAs) Archer MSAs were created to help self-employed individuals and employees of certain small employers meet the medical care costs of the account holder, the account holder's spouse, or the account holder's dependent(s). 1040ez form 2011 printable After December 31, 2007, you cannot be treated as an eligible individual for Archer MSA purposes unless: You were an active participant for any tax year ending before January 1, 2008, or You became an active participant for a tax year ending after December 31, 2007, by reason of coverage under a high deductible health plan (HDHP) of an Archer MSA participating employer. 1040ez form 2011 printable A Medicare Advantage MSA is an Archer MSA designated by Medicare to be used solely to pay the qualified medical expenses of the account holder who is eligible for Medicare. 1040ez form 2011 printable Archer MSAs An Archer MSA is a tax-exempt trust or custodial account that you set up with a U. 1040ez form 2011 printable S. 1040ez form 2011 printable financial institution (such as a bank or an insurance company) in which you can save money exclusively for future medical expenses. 1040ez form 2011 printable What are the benefits of an Archer MSA?   You may enjoy several benefits from having an Archer MSA. 1040ez form 2011 printable You can claim a tax deduction for contributions you make even if you do not itemize your deductions on Form 1040 or Form 1040NR. 1040ez form 2011 printable The interest or other earnings on the assets in your Archer MSA are tax free. 1040ez form 2011 printable Distributions may be tax free if you pay qualified medical expenses. 1040ez form 2011 printable See Qualified medical expenses , later. 1040ez form 2011 printable The contributions remain in your Archer MSA from year to year until you use them. 1040ez form 2011 printable An Archer MSA is “portable” so it stays with you if you change employers or leave the work force. 1040ez form 2011 printable Qualifying for an Archer MSA To qualify for an Archer MSA, you must be either of the following. 1040ez form 2011 printable An employee (or the spouse of an employee) of a small employer (defined later) that maintains a self-only or family HDHP for you (or your spouse). 1040ez form 2011 printable A self-employed person (or the spouse of a self-employed person) who maintains a self-only or family HDHP. 1040ez form 2011 printable You can have no other health or Medicare coverage except what is permitted under Other health coverage , later. 1040ez form 2011 printable You must be an eligible individual on the first day of a given month to get an Archer MSA deduction for that month. 1040ez form 2011 printable If another taxpayer is entitled to claim an exemption for you, you cannot claim a deduction for an Archer MSA contribution. 1040ez form 2011 printable This is true even if the other person does not actually claim your exemption. 1040ez form 2011 printable Small employer. 1040ez form 2011 printable   A small employer is generally an employer who had an average of 50 or fewer employees during either of the last 2 calendar years. 1040ez form 2011 printable The definition of small employer is modified for new employers and growing employers. 1040ez form 2011 printable Growing employer. 1040ez form 2011 printable   A small employer may begin HDHPs and Archer MSAs for his or her employees and then grow beyond 50 employees. 1040ez form 2011 printable The employer will continue to meet the requirement for small employers if he or she: Had 50 or fewer employees when the Archer MSAs began, Made a contribution that was excludable or deductible as an Archer MSA for the last year he or she had 50 or fewer employees, and Had an average of 200 or fewer employees each year after 1996. 1040ez form 2011 printable Changing employers. 1040ez form 2011 printable   If you change employers, your Archer MSA moves with you. 1040ez form 2011 printable However, you may not make additional contributions unless you are otherwise eligible. 1040ez form 2011 printable High deductible health plan (HDHP). 1040ez form 2011 printable   To be eligible for an Archer MSA, you must be covered under an HDHP. 1040ez form 2011 printable An HDHP has: A higher annual deductible than typical health plans, and A maximum limit on the annual out-of-pocket medical expenses that you must pay for covered expenses. 1040ez form 2011 printable Limits. 1040ez form 2011 printable   The following table shows the limits for annual deductibles and the maximum out-of-pocket expenses for HDHPs for 2013. 1040ez form 2011 printable   Self-only coverage Family coverage Minimum annual deductible $2,150 $4,300 Maximum annual deductible $3,200 $6,450 Maximum annual out-of-pocket expenses $4,300 $7,850 Family plans that do not meet the high deductible rules. 1040ez form 2011 printable   There are some family plans that have deductibles for both the family as a whole and for individual family members. 1040ez form 2011 printable Under these plans, if you meet the individual deductible for one family member, you do not have to meet the higher annual deductible amount for the family. 1040ez form 2011 printable If either the deductible for the family as a whole or the deductible for an individual family member is less than the minimum annual deductible for family coverage, the plan does not qualify as an HDHP. 1040ez form 2011 printable Example. 1040ez form 2011 printable You have family health insurance coverage in 2013. 1040ez form 2011 printable The annual deductible for the family plan is $5,500. 1040ez form 2011 printable This plan also has an individual deductible of $2,000 for each family member. 1040ez form 2011 printable The plan does not qualify as an HDHP because the deductible for an individual family member is less than the minimum annual deductible ($4,300) for family coverage. 1040ez form 2011 printable Other health coverage. 1040ez form 2011 printable   You (and your spouse, if you have family coverage) generally cannot have any other health coverage that is not an HDHP. 1040ez form 2011 printable However, you can still be an eligible individual even if your spouse has non-HDHP coverage provided you are not covered by that plan. 1040ez form 2011 printable However, you can have additional insurance that provides benefits only for the following items. 1040ez form 2011 printable Liabilities incurred under workers' compensation laws, torts, or ownership or use of property. 1040ez form 2011 printable A specific disease or illness. 1040ez form 2011 printable A fixed amount per day (or other period) of hospitalization. 1040ez form 2011 printable You can also have coverage (whether provided through insurance or otherwise) for the following items. 1040ez form 2011 printable Accidents. 1040ez form 2011 printable Disability. 1040ez form 2011 printable Dental care. 1040ez form 2011 printable Vision care. 1040ez form 2011 printable Long-term care. 1040ez form 2011 printable Contributions to an MSA Contributions to an Archer MSA must be made in cash. 1040ez form 2011 printable You cannot contribute stock or other property to an Archer MSA. 1040ez form 2011 printable Who can contribute to my Archer MSA?   If you are an employee, your employer may make contributions to your Archer MSA. 1040ez form 2011 printable (You do not pay tax on these contributions. 1040ez form 2011 printable ) If your employer does not make contributions to your Archer MSA, or you are self-employed, you can make your own contributions to your Archer MSA. 1040ez form 2011 printable Both you and your employer cannot make contributions to your Archer MSA in the same year. 1040ez form 2011 printable You do not have to make contributions to your Archer MSA every year. 1040ez form 2011 printable    If your spouse is covered by your HDHP and an excludable amount is contributed by your spouse's employer to an Archer MSA belonging to your spouse, you cannot make contributions to your own Archer MSA that year. 1040ez form 2011 printable Limits There are two limits on the amount you or your employer can contribute to your Archer MSA: The annual deductible limit. 1040ez form 2011 printable An income limit. 1040ez form 2011 printable Annual deductible limit. 1040ez form 2011 printable   You (or your employer) can contribute up to 75% of the annual deductible of your HDHP (65% if you have a self-only plan) to your Archer MSA. 1040ez form 2011 printable You must have the HDHP all year to contribute the full amount. 1040ez form 2011 printable If you do not qualify to contribute the full amount for the year, determine your annual deductible limit by using the worksheet in the Instructions for Form 8853, Archer MSAs and Long-Term Care Insurance Contracts. 1040ez form 2011 printable Example 1. 1040ez form 2011 printable You have an HDHP for your family all year in 2013. 1040ez form 2011 printable The annual deductible is $5,000. 1040ez form 2011 printable You can contribute up to $3,750 ($5,000 × 75%) to your Archer MSA for the year. 1040ez form 2011 printable Example 2. 1040ez form 2011 printable You have an HDHP for your family for the entire months of July through December 2013 (6 months). 1040ez form 2011 printable The annual deductible is $5,000. 1040ez form 2011 printable You can contribute up to $1,875 ($5,000 × 75% ÷ 12 × 6) to your Archer MSA for the year. 1040ez form 2011 printable If you and your spouse each have a family plan, you are treated as having family coverage with the lower annual deductible of the two health plans. 1040ez form 2011 printable The contribution limit is split equally between you unless you agree on a different division. 1040ez form 2011 printable Income limit. 1040ez form 2011 printable   You cannot contribute more than you earned for the year from the employer through whom you have your HDHP. 1040ez form 2011 printable   If you are self-employed, you cannot contribute more than your net self-employment income. 1040ez form 2011 printable This is your income from self-employment minus expenses (including the deductible part of self-employment tax). 1040ez form 2011 printable Example 1. 1040ez form 2011 printable Noah Paul earned $25,000 from ABC Company in 2013. 1040ez form 2011 printable Through ABC, he had an HDHP for his family for the entire year. 1040ez form 2011 printable The annual deductible was $5,000. 1040ez form 2011 printable He can contribute up to $3,750 to his Archer MSA (75% × $5,000). 1040ez form 2011 printable He can contribute the full amount because he earned more than $3,750 at ABC. 1040ez form 2011 printable Example 2. 1040ez form 2011 printable Westley Lawrence is self-employed. 1040ez form 2011 printable He had an HDHP for his family for the entire year in 2013. 1040ez form 2011 printable The annual deductible was $5,000. 1040ez form 2011 printable Based on the annual deductible, the maximum contribution to his Archer MSA would have been $3,750 (75% × $5,000). 1040ez form 2011 printable However, after deducting his business expenses, Joe's net self-employment income is $2,500 for the year. 1040ez form 2011 printable Therefore, he is limited to a contribution of $2,500. 1040ez form 2011 printable Individuals enrolled in Medicare. 1040ez form 2011 printable   Beginning with the first month you are enrolled in Medicare, you cannot contribute to an Archer MSA. 1040ez form 2011 printable However, you may be eligible for a Medicare Advantage MSA, discussed later. 1040ez form 2011 printable When To Contribute You can make contributions to your Archer MSA for 2013 until April 15, 2014. 1040ez form 2011 printable Reporting Contributions on Your Return Report all contributions to your Archer MSA on Form 8853 and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable You should include all contributions you, or your employer, made for 2013, including those made by April 15, 2014, that are designated for 2013. 1040ez form 2011 printable You should receive Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information, from the trustee showing the amount you (or your employer) contributed during the year. 1040ez form 2011 printable Your employer's contributions should be shown in box 12 of Form W-2, Wage and Tax Statement, with code R. 1040ez form 2011 printable Follow the instructions for Form 8853 and complete the worksheet in the instructions. 1040ez form 2011 printable Report your Archer MSA deduction on Form 1040 or Form 1040NR. 1040ez form 2011 printable Excess contributions. 1040ez form 2011 printable   You will have excess contributions if the contributions to your Archer MSA for the year are greater than the limits discussed earlier. 1040ez form 2011 printable Excess contributions are not deductible. 1040ez form 2011 printable Excess contributions made by your employer are included in your gross income. 1040ez form 2011 printable If the excess contribution is not included in box 1 of Form W-2, you must report the excess as “Other income” on your tax return. 1040ez form 2011 printable   Generally, you must pay a 6% excise tax on excess contributions. 1040ez form 2011 printable See Form 5329, Additional Taxes on Qualified Plans (Including IRAs) and Other Tax-Favored Accounts, to figure the excise tax. 1040ez form 2011 printable The excise tax applies to each tax year the excess contribution remains in the account. 1040ez form 2011 printable   You may withdraw some or all of the excess contributions and not pay the excise tax on the amount withdrawn if you meet the following conditions. 1040ez form 2011 printable You withdraw the excess contributions by the due date, including extensions, of your tax return. 1040ez form 2011 printable You withdraw any income earned on the withdrawn contributions and include the earnings in “Other income” on your tax return for the year you withdraw the contributions and earnings. 1040ez form 2011 printable Deducting an excess contribution in a later year. 1040ez form 2011 printable   You may be able to deduct excess contributions for previous years that are still in your Archer MSA. 1040ez form 2011 printable The excess contribution you can deduct in the current year is the lesser of the following two amounts. 1040ez form 2011 printable Your maximum Archer MSA contribution limit for the year minus any amounts contributed to your Archer MSA for the year. 1040ez form 2011 printable The total excess contributions in your Archer MSA at the beginning of the year. 1040ez form 2011 printable   Any excess contributions remaining at the end of a tax year are subject to the excise tax. 1040ez form 2011 printable See Form 5329. 1040ez form 2011 printable Distributions From an MSA You will generally pay medical expenses during the year without being reimbursed by your HDHP until you reach the annual deductible for the plan. 1040ez form 2011 printable When you pay medical expenses during the year that are not reimbursed by your HDHP, you can ask the trustee of your Archer MSA to send you a distribution from your Archer MSA. 1040ez form 2011 printable You can receive tax-free distributions from your Archer MSA to pay for qualified medical expenses (discussed later). 1040ez form 2011 printable If you receive distributions for other reasons, the amount will be subject to income tax and may be subject to an additional 20% tax as well. 1040ez form 2011 printable You do not have to make withdrawals from your Archer MSA each year. 1040ez form 2011 printable If you no longer qualify to make contributions, you can still receive tax-free distributions to pay or reimburse your qualified medical expenses. 1040ez form 2011 printable A distribution is money you get from your Archer MSA. 1040ez form 2011 printable The trustee will report any distribution to you and the IRS on Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA. 1040ez form 2011 printable Qualified medical expenses. 1040ez form 2011 printable   Qualified medical expenses are those expenses that would generally qualify for the medical and dental expenses deduction. 1040ez form 2011 printable These are explained in Publication 502. 1040ez form 2011 printable   Also, non-prescription medicines (other than insulin) are not considered qualified medical expenses for MSA purposes. 1040ez form 2011 printable A medicine or drug will be a qualified medical expense for MSA purposes only if the medicine or drug: Requires a prescription, Is available without a prescription (an over-the-counter medicine or drug) and you get a prescription for it, or Is insulin. 1040ez form 2011 printable   Qualified medical expenses are those incurred by the following persons. 1040ez form 2011 printable You and your spouse. 1040ez form 2011 printable All dependents you claim on your tax return. 1040ez form 2011 printable Any person you could have claimed as a dependent on your return except that: The person filed a joint return, The person had gross income of $3,900 or more, or You, or your spouse if filing jointly, could be claimed as a dependent on someone else's 2013 return. 1040ez form 2011 printable    For this purpose, a child of parents that are divorced, separated, or living apart for the last 6 months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child's exemption. 1040ez form 2011 printable    You cannot deduct qualified medical expenses as an itemized deduction on Schedule A (Form 1040) that are equal to the tax-free distribution from your Archer MSA. 1040ez form 2011 printable Special rules for insurance premiums. 1040ez form 2011 printable   Generally, you cannot treat insurance premiums as qualified medical expenses for Archer MSAs. 1040ez form 2011 printable You can, however, treat premiums for long-term care coverage, health care coverage while you receive unemployment benefits, or health care continuation coverage required under any federal law as qualified medical expenses for Archer MSAs. 1040ez form 2011 printable Health coverage tax credit. 1040ez form 2011 printable   You cannot claim this credit for premiums that you pay with a tax-free distribution from your Archer MSA. 1040ez form 2011 printable See Publication 502 for information on this credit. 1040ez form 2011 printable Deemed distributions from Archer MSAs. 1040ez form 2011 printable   The following situations result in deemed taxable distributions from your Archer MSA. 1040ez form 2011 printable You engaged in any transaction prohibited by section 4975 with respect to any of your Archer MSAs at any time in 2013. 1040ez form 2011 printable Your account ceases to be an Archer MSA as of January 1, 2013, and you must include the fair market value of all assets in the account as of January 1, 2013, on Form 8853. 1040ez form 2011 printable You used any portion of any of your Archer MSAs as security for a loan at any time in 2013. 1040ez form 2011 printable You must include the fair market value of the assets used as security for the loan as income on Form 1040 or Form 1040NR. 1040ez form 2011 printable   Examples of prohibited transactions include the direct or indirect: Sale, exchange, or leasing of property between you and the Archer MSA, Lending of money between you and the Archer MSA, Furnishing goods, services, or facilities between you and the Archer MSA, and Transfer to or use by you, or for your benefit, of any assets of the Archer MSA. 1040ez form 2011 printable   Any deemed distribution will not be treated as used to pay qualified medical expenses. 1040ez form 2011 printable These distributions are included in your income and are subject to the additional 20% tax, discussed later. 1040ez form 2011 printable Recordkeeping. 1040ez form 2011 printable You must keep records sufficient to show that: The distributions were exclusively to pay or reimburse qualified medical expenses, The qualified medical expenses had not been previously paid or reimbursed from another source, and The medical expenses had not been taken as an itemized deduction in any year. 1040ez form 2011 printable Do not send these records with your tax return. 1040ez form 2011 printable Keep them with your tax records. 1040ez form 2011 printable Reporting Distributions on Your Return How you report your distributions depends on whether or not you use the distribution for qualified medical expenses (defined earlier). 1040ez form 2011 printable If you use a distribution from your Archer MSA for qualified medical expenses, you do not pay tax on the distribution but you have to report the distribution on Form 8853. 1040ez form 2011 printable Follow the instructions for the form and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable If you do not use a distribution from your Archer MSA for qualified medical expenses, you must pay tax on the distribution. 1040ez form 2011 printable Report the amount on Form 8853 and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable You may have to pay an additional 20% tax, discussed later, on your taxable distribution. 1040ez form 2011 printable If an amount (other than a rollover) is contributed to your Archer MSA this year (by you or your employer), you also must report and pay tax on a distribution you receive from your Archer MSA this year that is used to pay medical expenses of someone who is not covered by an HDHP, or is also covered by another health plan that is not an HDHP, at the time the expenses are incurred. 1040ez form 2011 printable Rollovers. 1040ez form 2011 printable   Generally, any distribution from an Archer MSA that you roll over into another Archer MSA or an HSA is not taxable if you complete the rollover within 60 days. 1040ez form 2011 printable An Archer MSA and an HSA can only receive one rollover contribution during a 1-year period. 1040ez form 2011 printable See the Form 8853 instructions for more information. 1040ez form 2011 printable Additional tax. 1040ez form 2011 printable   There is a 20% additional tax on the part of your distributions not used for qualified medical expenses. 1040ez form 2011 printable Figure the tax on Form 8853 and file it with your Form 1040 or Form 1040NR. 1040ez form 2011 printable Report the additional tax in the total on Form 1040 or Form 1040NR. 1040ez form 2011 printable Exceptions. 1040ez form 2011 printable   There is no additional tax on distributions made after the date you are disabled, reach age 65, or die. 1040ez form 2011 printable Balance in an Archer MSA An Archer MSA is generally exempt from tax. 1040ez form 2011 printable You are permitted to take a distribution from your Archer MSA at any time; however, only those amounts used exclusively to pay for qualified medical expenses are tax free. 1040ez form 2011 printable Amounts that remain at the end of the year are generally carried over to the next year (see Excess contributions , earlier). 1040ez form 2011 printable Earnings on amounts in an Archer MSA are not included in your income while held in the Archer MSA. 1040ez form 2011 printable Death of the Archer MSA Holder You should choose a beneficiary when you set up your Archer MSA. 1040ez form 2011 printable What happens to that Archer MSA when you die depends on whom you designate as the beneficiary. 1040ez form 2011 printable Spouse is the designated beneficiary. 1040ez form 2011 printable   If your spouse is the designated beneficiary of your Archer MSA, it will be treated as your spouse's Archer MSA after your death. 1040ez form 2011 printable Spouse is not the designated beneficiary. 1040ez form 2011 printable   If your spouse is not the designated beneficiary of your Archer MSA: The account stops being an Archer MSA, and The fair market value of the Archer MSA becomes taxable to the beneficiary in the year in which you die. 1040ez form 2011 printable   If your estate is the beneficiary, the fair market value of the Archer MSA will be included on your final income tax return. 1040ez form 2011 printable The amount taxable to a beneficiary other than the estate is reduced by any qualified medical expenses for the decedent that are paid by the beneficiary within 1 year after the date of death. 1040ez form 2011 printable Filing Form 8853 You must file Form 8853 with your Form 1040 or Form 1040NR if you (or your spouse, if married filing a joint return) had any activity in your Archer MSA during the year. 1040ez form 2011 printable You must file the form even if only your employer or your spouse's employer made contributions to the Archer MSA. 1040ez form 2011 printable If, during the tax year, you are the beneficiary of two or more Archer MSAs or you are a beneficiary of an Archer MSA and you have your own Archer MSA, you must complete a separate Form 8853 for each MSA. 1040ez form 2011 printable Enter “statement” at the top of each Form 8853 and complete the form as instructed. 1040ez form 2011 printable Next, complete a controlling Form 8853 combining the amounts shown on each of the statement Forms 8853. 1040ez form 2011 printable Attach the statements to your tax return after the controlling Form 8853. 1040ez form 2011 printable Employer Participation This section contains the rules that employers must follow if they decide to make Archer MSAs available to their employees. 1040ez form 2011 printable Unlike the previous discussions, “you” refers to the employer and not to the employee. 1040ez form 2011 printable Health plan. 1040ez form 2011 printable   If you want your employees to be able to have an Archer MSA, you must make an HDHP available to them. 1040ez form 2011 printable You can provide no additional coverage other than those exceptions listed previously under Other health coverage . 1040ez form 2011 printable Contributions. 1040ez form 2011 printable   You can make contributions to your employees' Archer MSAs. 1040ez form 2011 printable You deduct the contributions on the “Employee benefit programs” line of your business income tax return for the year in which you make the contributions. 1040ez form 2011 printable If you are filing Form 1040, Schedule C, this is Part II, line 14. 1040ez form 2011 printable Comparable contributions. 1040ez form 2011 printable   If you decide to make contributions, you must make comparable contributions to all comparable participating employees' Archer MSAs. 1040ez form 2011 printable Your contributions are comparable if they are either: The same amount, or The same percentage of the annual deductible limit under the HDHP covering the employees. 1040ez form 2011 printable Comparable participating employees. 1040ez form 2011 printable   Comparable participating employees: Are covered by your HDHP and are eligible to establish an Archer MSA, Have the same category of coverage (either self-only or family coverage), and Have the same category of employment (either part-time or full-time). 1040ez form 2011 printable Excise tax. 1040ez form 2011 printable   If you made contributions to your employees' Archer MSAs that were not comparable, you must pay an excise tax of 35% of the amount you contributed. 1040ez form 2011 printable Employment taxes. 1040ez form 2011 printable   Amounts you contribute to your employees' Archer MSAs are generally not subject to employment taxes. 1040ez form 2011 printable You must report the contributions in box 12 of the Form W-2 you file for each employee. 1040ez form 2011 printable Enter code “R” in box 12. 1040ez form 2011 printable Medicare Advantage MSAs A Medicare Advantage MSA is an Archer MSA designated by Medicare to be used solely to pay the qualified medical expenses of the account holder. 1040ez form 2011 printable To be eligible for a Medicare Advantage MSA, you must be enrolled in Medicare and have a high deductible health plan (HDHP) that meets the Medicare guidelines. 1040ez form 2011 printable A Medicare Advantage MSA is a tax-exempt trust or custodial savings account that you set up with a financial institution (such as a bank or an insurance company) in which the Medicare program can deposit money for qualified medical expenses. 1040ez form 2011 printable The money in your account is not taxed if it is used for qualified medical expenses, and it may earn interest or dividends. 1040ez form 2011 printable An HDHP is a special health insurance policy that has a high deductible. 1040ez form 2011 printable You choose the policy you want to use as part of your Medicare Advantage MSA plan. 1040ez form 2011 printable However, the policy must be approved by the Medicare program. 1040ez form 2011 printable Medicare Advantage MSAs are administered through the federal Medicare program. 1040ez form 2011 printable You can get information by calling 1-800-Medicare (1-800-633-4227) or through the Internet at www. 1040ez form 2011 printable medicare. 1040ez form 2011 printable gov. 1040ez form 2011 printable Note. 1040ez form 2011 printable You must file Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, with your tax return if you have a Medicare Advantage MSA. 1040ez form 2011 printable Flexible Spending Arrangements (FSAs) A health flexible spending arrangement (FSA) allows employees to be reimbursed for medical expenses. 1040ez form 2011 printable FSAs are usually funded through voluntary salary reduction agreements with your employer. 1040ez form 2011 printable No employment or federal income taxes are deducted from your contribution. 1040ez form 2011 printable The employer may also contribute. 1040ez form 2011 printable Note. 1040ez form 2011 printable Unlike HSAs or Archer MSAs which must be reported on Form 1040 or Form 1040NR, there are no reporting requirements for FSAs on your income tax return. 1040ez form 2011 printable For information on the interaction between a health FSA and an HSA, see Other employee health plans under Qualifying for an HSA, earlier. 1040ez form 2011 printable What are the benefits of an FSA?   You may enjoy several benefits from having an FSA. 1040ez form 2011 printable Contributions made by your employer can be excluded from your gross income. 1040ez form 2011 printable No employment or federal income taxes are deducted from the contributions. 1040ez form 2011 printable Withdrawals may be tax free if you pay qualified medical expenses. 1040ez form 2011 printable See Qualified medical expenses , later. 1040ez form 2011 printable You can withdraw funds from the account to pay qualified medical expenses even if you have not yet placed the funds in the account. 1040ez form 2011 printable Qualifying for an FSA Health FSAs are employer-established benefit plans. 1040ez form 2011 printable These may be offered in conjunction with other employer-provided benefits as part of a cafeteria plan. 1040ez form 2011 printable Employers have complete flexibility to offer various combinations of benefits in designing their plan. 1040ez form 2011 printable You do not have to be covered under any other health care plan to participate. 1040ez form 2011 printable Self-employed persons are not eligible for an FSA. 1040ez form 2011 printable Certain limitations may apply if you are a highly compensated participant or a key employee. 1040ez form 2011 printable Contributions to an FSA You contribute to your FSA by electing an amount to be voluntarily withheld from your pay by your employer. 1040ez form 2011 printable This is sometimes called a salary reduction agreement. 1040ez form 2011 printable The employer may also contribute to your FSA if specified in the plan. 1040ez form 2011 printable You do not pay federal income tax or employment taxes on the salary you contribute or the amounts your employer contributes to the FSA. 1040ez form 2011 printable However, contributions made by your employer to provide coverage for long-term care insurance must be included in income. 1040ez form 2011 printable When To Contribute At the