A Health Savings Account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account are not subject to federal income tax at the time of deposit. Funds may be used to pay for qualified medical expenses at any time without federal tax liability. See below for additional information:
General Questions
What is a Health Savings Account?
A Health Savings Account ("HSA") is a tax-exempt trust or custodial account created for the purpose of saving and paying for qualified medical expenses in connection with a high deductible health plan. Authorized by Section 1201 of the Medicare Prescription Drug Improvement and Modernization Act of 2003, an HSA is established for the benefit of an individual, and is "portable." This means that if you change employers or leave the work force, the HSA stays with you rather than with your former employer. Your HSA at UMB Bank, n.a. is a custodial account that consists of all funds you or your employer contributes to your HSA, all investments you make with or through Custodian using those funds, and all earnings on those funds.
Who can offer a high-deductible health plan?
A high-deductible health plan may be offered by a variety of entities, including insurance companies and Health Maintenance Organizations (HMOs).
Can you be covered by another health plan and still be eligible for an HSA?
Except as provided below, you are ineligible for an HSA if you are covered under another health plan (whether as an individual, spouse or dependent) in addition to your qualified high-deductible health plan. You may be covered by two qualified HDHPs.
What other types of health coverage can you maintain without losing eligibility for an HSA?
You remain eligible for an HSA if, in addition to a high-deductible health plan, you have any one or more of the following:
- insurance under which substantially all of the coverage relates to liabilities from workers' compensation laws, torts, or ownership or use of property (such as automobile insurance)
- insurance for a specified disease or illness
- insurance paying a fixed amount per day (or other period) of hospitalization
- coverage (whether through insurance or otherwise) for accidents, disability, dental care, vision care, or long-term care.
You may also have coverage under an Employee Assistance Program (EAP), and you may have a discount card that enables you to obtain discounts for health care services or products at managed care market rates.
Are HSAs allowed under a cafeteria plan?
A high-deductible health plan can be provided as part of a cafeteria plan. Such a high-deductible health plan can be used in conjunction with an HSA. The HSA can be established under a cafeteria plan.
Can an employer allow you to elect an HSA mid-year if offered as a new benefit under the employer's cafeteria plan?
An employer may offer an HSA mid-year as a new benefit under a cafeteria plan, and allow you to elect an HSA, so long as your election for the HSA is made on a prospective basis. In such a situation, however, you may have other coverage under the cafeteria plan that cannot be changed (e.g., coverage under a health flexible spending account), which may prevent you from being an eligible individual with respect to the HSA.
Opening an HSA
How do you establish an HSA?
If you are eligible for an HSA, you can establish an HSA with a qualified HSA trustee or custodian. No permission or authorization from the Internal Revenue Service (IRS) is necessary. The trustee or custodian will furnish you a written HSA custodial or trust agreement.
Who can serve as an HSA trustee or custodian?
Any insurance company or any bank (including a similar financial institution as defined in Section 408(n) of the Code) can be an HSA trustee or custodian. In addition, any other persons already approved by the IRS to be trustees or custodians of IRAs are automatically approved to be HSA trustees or custodians.
HSA Contributions
Who may contribute to an HSA?
Any person (an eligible individual, an employer, a family member, or any other person) may make contributions to an HSA on behalf of an eligible individual.
What are the rules regarding contributions made by your employer?
If your employer makes a contribution to the HSA, your employer will be subject to a "comparability test." If your employer provides a high-deductible health plan and makes HSA contributions for some employees, then your employer is required to make available comparable contributions on behalf of all employees with comparable coverage. For this purpose, the term "comparable contributions" means contributions that are either (i) the same amount, or (ii) the same percentage of the annual deductible limit under the high-deductible health plan.
In what form may contributions be made to an HSA?
Contributions to an HSA must be made in cash. The custodian will accept contributions by check or direct deposit. The custodian will also accept rollovers or transfers of assets from an Archer MSA or an HSA, in accordance with the requirements of the Internal Revenue Code. The custodian will require that those rollover contributions be in the form of cash.
How much may be contributed to an HSA?
The maximum amount that may be contributed to an HSA is an amount established by the IRS for each year (depending on whether you have single coverage or family coverage). The amounts established by the IRS for 2008 are $2,900 for individual coverage and $5,800 for family coverage. You should check with your legal or tax advisor to determine the limit that applies to you for the current year. The same annual contribution limit applies regardless of whether the contributions
are made by an employee, an employer, or both.
The total contribution for the year can be made in one or more payments at any time up to your tax-filing deadline (without extensions). However, if you wish to have a contribution made between January 1 and April 15 treated as a contribution
for the preceding taxable year, you must provide written notification to UMB at the time such contribution is made. Otherwise, it will be treated as a contribution for the current taxable year. The annual limit is decreased by aggregate contributions to a medical savings account (Archer MSA).
When may "catch-up" contributions be made to an HSA?
If you are age 55 or over, you can make additional "catch-up" contributions to your HSA. The amount of this additional "catch-up" contribution is $900 for 2008. This additional "catch-up" amount increases by $100 for each year after 2008, but for 2009 and later years, the maximum additional "catch-up" contribution is $1,000.
When is the deadline for contributions to an HSA for any particular year?
You may make HSA contributions for a particular year no later than the deadline, without extensions, for filing your federal income tax return for that year. For calendar year taxpayers, this is generally April 15 following the year for which the contributions were made. However, the custodian will treat any contribution made between January 1 and April 15 as a contribution for the current taxable year unless you provide written notice to the custodian at the time of such contribution that the contribution is for the preceding taxable year.
What happens when HSA contributions exceed the amount that may be deducted or excluded from gross income?
A contribution made by you or your employer to an HSA that exceeds the amount allowed by law, or which is made during any year when you are not eligible to contribute, is called an "excess contribution." Excess contributions are not deductible by you or your employer and are included in your gross income if made on your behalf by your employer. In addition, excess contributions are subject to a six percent excise tax for each year they remain in your HSA.
However, you may avoid this excise tax if the excess contribution is not deducted and if you remove the excess contribution from your HSA, together with any net income attributable to the excess contribution, before the due date for filing your federal income tax return, including extensions, for the year for which the excess contribution was made.
In that case, the net income attributable to the excess contribution would be taxable as income for the year in which the distribution is made, but the removed excess contribution would not be taxable as income to you. Rollover contributions
do not count in determining whether an excess contribution has been made.
Who is responsible for determining the amount of eligible contributions?
You are responsible for determining your eligibility for an HSA and the amount of eligible contributions during any year. You are encouraged to speak with your tax advisor about these matters. The custodian has no responsibility for determining or advising you whether any contribution complies with the requirements and limitations of the Code.
When will the custodian return excess contributions?
The custodian will return contributions that the custodian believes in good faith would exceed the sum of the maximum annual family coverage deductible plus the catch-up contribution amount as determined by the IRS. Since maximum annual contribution limits may vary depending on whether you have individual or family coverage, your policy deductible amount and your age, you should not rely on us to determine whether your contributions exceed the maximum annual contribution. The custodian will also return contributions when you notify us that you have made an excess contribution. You may be charged a fee on a returned contribution.
Rollovers and Transfers
What are the rules regarding rollovers and transfers of HSAs?
You may withdraw any portion or all of the funds from one HSA or Archer Medical Savings Account (MSA) and roll them to an HSA account with another custodian or trustee. However, you are required to roll the funds into a new HSA within 60 calendar days of your receipt of the funds. Another rule provides that you are only allowed to make one HSA rollover in a 12-month period. The 12-month period begins on the date you receive the distribution, not on the date you roll it to another HSA. In addition, you may transfer your Archer MSA or HSA funds directly from one HSA custodian or trustee to another without ever having direct control or custody of the funds. Rollover and transfer contributions are not deductible and do not count against the annual contribution limits.
Federal Tax Treatment of HSAs
What is the tax treatment of an eligible individual's HSA contributions?
When you make an eligible contribution to an HSA, the amount of your contribution (up to the maximum contribution limit discussed above) is deductible in computing your adjusted gross income. This means your contributions are deductible whether or not you itemize deductions. In addition, any person who may be claimed as a dependent on another taxpayer's return may not claim a deduction for a contribution to an HSA. A special rule applies to certain married individuals. If either spouse has family coverage under a high-deductible health plan, both spouses shall be treated as having only such family coverage (and if such spouses each have family coverage under different plans, as having the family coverage with the lowest annual deductible). The amount allowable as a deduction after application of this rule shall be divided equally between the spouses unless they agree on a different division.
What is the tax treatment of employer contributions to an HSA?
If your employer makes a contribution to an HSA for you, you are not allowed to deduct that contribution on your income tax return. Your employer, however, will be able to deduct the contribution up to your maximum contribution limit for that year. Although you cannot deduct your employer's HSA contribution, the contribution is not taxable to you or subject to income tax withholding or other employment taxes if it does not exceed your maximum contribution limit for that year.
What is the tax treatment of earnings on amounts in an HSA?
Earnings on amounts in an HSA are not taxable prior to distribution from the HSA. However, HSAs are subject to the taxes imposed by Section 511 of the Code (relating to tax on unrelated business income of charitable, etc., organizations). In addition, under certain circumstances, distributions from an HSA may have tax consequences.
What are the tax consequences of a "prohibited transaction?
If you or your beneficiary engage in a "prohibited transaction" as described in Section 4975 of the Code with respect to your HSA, it will lose its tax exemption and its fair market value will be added to your gross income for the year in which the prohibited transaction takes place. In addition to any regular income tax that may be payable, the 10 percent premature distribution penalty tax may also be applicable.
Are there any tax consequences to pledging your HSA as security for a loan?
Any portion of your HSA that you pledge as security for a loan will be treated as being distributed to you in that year. In addition to any regular income tax that may be payable, the 10 percent premature distribution penalty tax may also be applicable.
Will your custodian provide any tax advice in connection with your HSA?
As custodian, UMB will provide no tax advice concerning your HSA. The tax consequences of your HSA, including all contributions to and distributions from your HSA, are your sole responsibility. You are encouraged to discuss any questions with your own tax advisor.
Note: The above discussion relates to federal taxation, not state.
Distributions from HSAs
When can you receive distributions from an HSA?
You can take a distribution from your HSA at any time.
How are distributions from an HSA taxed?
Distributions from an HSA are generally excludable from income for federal income tax purposes if such expenses are not covered by insurance. Distributions used for any other purpose are includible in income and may also be subject to an additional 10 percent tax (see below).
When are you subject to the 10 percent premature distribution penalty tax?
Generally, if an HSA distribution is included in your gross income because it is not made for "qualified medical expenses," it will also be subject to an additional 10 percent premature distribution penalty tax. This 10 percent penalty tax does not apply to distributions made after your death, disability or attainment of age 65.
What happens if you receive an HSA distribution as the result of a mistake of fact due to reasonable cause?
If there is clear and convincing evidence that amounts were distributed from an HSA because of a mistake of fact due to reasonable cause, you may repay the mistaken distribution no later than April 15 following the first year you knew or should have known the distribution was a mistake. Under these circumstances, the distribution is not included in your gross income or subject to the 10 percent additional tax, and the repayment is not subject to the six percent excise tax for excess contributions.
What medical expenses are eligible for tax-free distributions from your HSA?
Distributions made for "qualified medical expenses" are generally excludable from income. For this purpose, the term "qualified medical expenses" means amounts paid for the medical care, as defined in Section 213(d) of the Code, of yourself, your spouse, or your dependents, but only to the extent such amounts are not compensated by insurance or otherwise. This includes amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body, as well as for transportation primarily for and essential to such care.
Qualified medical expenses do not include insurance premiums other than premiums for long-term care insurance, premiums on a health plan during any period of continuation coverage required by federal law (e.g., COBRA coverage), or premiums for health care coverage while an individual receives unemployment compensation. The IRS publishes a complete list and description of these expenses in Publication 502, Medical and Dental Expenses, which is available at www.irs.gov.
Typical expenses include:
- Medical expenses, insurance deductibles, co-pays, and other eligible expenses not covered by insurance
- Hospital charges
- Prescription drugs
- Medical supplies
- Over-the-counter drugs
- Eyeglasses, contact lenses, solutions and eye surgery
- Vitamins, dietary supplements, weight loss drugs, if approved by your doctor
- Dental services, orthodontics and psychologist's fees
- Smoking cessation programs and related over-the-counter drugs
Is your custodian responsible for determining whether HSA distributions are used for medical expenses?
As custodian, UMB has no responsibility for determining whether distributions from your HSA are used for qualified medical expenses. It is your sole responsibility to determine the tax consequences of any distributions, for maintaining adequate records for tax purposes, and for paying any taxes and penalties arising as a result of any such distribution. You are encouraged to consult with your legal or tax advisor concerning any questions you may have.
If I am a retiree and age 65 or older, may I receive tax-free distributions from an HSA to pay my contribution to my employer's retiree health coverage?
After you reach age 65, you may receive tax-free distributions from an HSA to pay for your employer's retiree health insurance coverage. Although the purchase of health insurance is generally not a qualified medical expense that can be
paid or reimbursed by an HSA, the Code provides an exception for coverage for health insurance once an account beneficiary reaches age 65. This exception applies to both insured and self-insured plans.
If I am a retiree who is enrolled in Medicare, may I receive a tax-free distribution from an HSA to reimburse my Medicare premiums?
Such a distribution will be tax-free. When premiums for Medicare are deducted from Social Security benefit payments, an HSA distribution to reimburse an amount equal to the Medicare premium deduction is a qualified medical expense.
Divorce or Death of HSA Account Holder
What are the rules that apply if your HSA is transferred pursuant to a divorce decree?
The transfer of your HSA to your spouse pursuant to a divorce decree is not considered a taxable transfer. After such transfer, the former spouse will be treated as the account holder of the HSA, but the former spouse must request UMB to transfer the account to his or her name, must provide UMB with a certified copy of the divorce decree and property settlement or transfer agreement, and must sign appropriate documents to establish the account in that person's name.
What happens to your HSA upon your death?
You have the right at any time to designate one or more beneficiaries to whom distribution of your HSA will be made upon your death. You also have the right to revoke a prior beneficiary designation and, if desired, designate different individuals as beneficiaries. To be valid, any such beneficiary designation must be delivered to UMB prior to your death on a form provided by or acceptable to UMB.
In the absence of a valid beneficiary designation, UMB will distribute the assets comprising your HSA upon your death to your estate. You should understand that in certain states, your spouse's consent may be necessary if you wish to name
a person other than or in addition to your spouse as beneficiary or to change an existing beneficiary designation. You should consult with your attorney before making such a beneficiary designation.
What are the tax consequences of HSA distributions following your death?
If your spouse is the named beneficiary of your HSA, your HSA becomes the HSA of your spouse upon your death, subject to UMB's consent and the completion of applicable documents as required by UMB. The surviving spouse is not required to include any amount in gross income for tax purposes as a result of your death and he or she is subject to income tax only on those distributions that are not made for qualified medical expenses.
If, at your death, your HSA passes to a named beneficiary other than your surviving spouse, the HSA ceases to be an HSA as of the date of your death, and the beneficiary is required to include the fair market value of the HSA assets as of the date of death in his or her gross income for the taxable year that includes the date of death. The includible amount is reduced by the amount in the HSA used, within one year of your death, to pay your qualified medical expenses incurred prior to death. If there is no named beneficiary of your HSA, the HSA ceases to be an HSA as of the date of your death, and the fair market value of the HSA assets as of the date of death is includible in your gross income for the year of death.
Statements and Filing Requirements
What information must be filed with the IRS?
As custodian, UMB will send each year to the IRS and to you a form, showing a valuation of your HSA as of December 31 of the prior year, and a report of the contributions to your HSA for the prior year. Unless UMB receives either a certification from your employer that contributions were made by the employer, or a notification from you that a contribution is a rollover contribution, all contributions will be reported as tax-deductible contributions made by you. Distributions will be reported by UMB on Form 1099.
Unless you provide written notice to the contrary, UMB will conclusively assume that any distribution, whether by check, debit card, or otherwise, is a "normal distribution" for purposes of tax reporting. Normal distributions include distributions
for qualified medical expenses, and expressly exclude the following: return of excess contributions, distributions following your disability, distributions following your death, and prohibited transactions. If a distribution falls within
one of these exceptions, you must provide written notification to UMB within seven days following such distribution.
Miscellaneous
Other Legal Requirements:
In addition to the legal requirements, your HSA is subject to the following rules:
- None of the funds of your HSA may be invested in life insurance contracts.
- With the exception of investments in a common trust fund or common investment fund, no assets of your HSA may be commingled.
- Your interest in the balance of the HSA custodial account is not forfeitable.