Brught t yu by Haylr, Freyer & Cn, Inc. Health Savings Accunts (HSAs) Distributin Rules A Health Savings Accunt (HSA) is a trust r accunt used t pay medical expenses that a high deductible health plan (HDHP) des nt pay. HSAs ffer triple tax advantages t accunt wners, including tax exemptins fr cntributins, earnings and distributins. T btain the last exemptin, HSA hlders must fllw strict rules fr spending HSA funds. Emplyers that ffer HSA prgrams generally have very little, if any, invlvement in HSA distributins. HSA wners have sle discretin fr hw and when t use HSA funds, and an HSA custdian r trustee tracks and reprts all HSA activity. Nevertheless, sme distributin rules may apply t r affect emplyers. This Legislative Brief makes special nte f these while summarizing the rules applicable t HSA wners wh receive mney frm an HSA. WHAT IS AN HSA DISTRIBUTION? In simple terms, an HSA distributin is any mney an HSA wner takes ut f an HSA. HSA wners and anyne they designate are free t take mney frm an HSA fr any purpse. If certain rules are fllwed, the distributin is nt taxable. Hwever, if any prtin f a distributin is nt used in accrdance with HSA rules, that prtin is taxable as incme t the HSA wner. When an HSA distributin is taxable, it is als subject t a 20 percent penalty unless the HSA wner is ver age 65, disabled r deceased. This chart prvides a guide fr determining whether an HSA distributin is taxable and subject t the 20 percent penalty. The specific requirements are discussed in mre detail belw. Was the mney used fr a Qualified (QME)? Was the QME incurred after the HSA was established? Was the QME incurred by the HSA wner r his r her spuse r dependents? At the time f the distributin, was the HSA wner: HSA Distributin is: Taxable as incme & subject t 20 percent penalty Did r will any health plan pay the QME? 65 r lder; Disabled; Taxable as incme Did r will anyne claim the QME as a medical expense deductin? r Deceased*? *tax treatment may depend n ther factrs 1
HOW ARE HSA DISTRIBUTIONS ADMINISTERED? HSA funds must be held by an apprved HSA custdian r trustee. Once mney is in an HSA, it belngs slely t the accunt wner, wh has cmplete cntrl ver hw t spend it. An emplyer that cntributes funds t an emplyee s HSA cannt make a custdian r trustee refund the mney, even if the amunts depsited exceed cntributin limits. Neither an emplyer nr an HSA custdian r trustee is required t determine whether HSA distributins are used fr qualified medical expenses. This is ne f the main features that distinguishes HSAs frm health flexible spending accunts (FSAs) and health reimbursement arrangements (HRAs). Emplyers can chse the custdian r trustee t set up emplyees HSAs, but they cannt restrict emplyees frm making withdrawals r transferring HSA funds t a different HSA. If an emplyer chses an HSA that allws emplyees t access their HSA funds thrugh a health-care restricted debit card, the accunt funds must als be readily available t the HSA wner thrugh cash withdrawal r ther distributin methds. The emplyer must ntify emplyees abut the alternate means f accessing funds. An HSA custdian r trustee can place reasnable administrative restrictins n HSA wner s distributins, generally limited t setting a minimum dllar amunt fr single distributins and a maximum number f distributins per mnth. The custdian r trustee may als withdraw funds frm an HSA t cver its administrative fees, but these amunts are nt cnsidered distributins. WHEN MAY HSA DISTRIBUTIONS OCCUR? HSA funds cannt be used fr expenses incurred prir t the date the HSA was established. In ther wrds, a distributin is taxable (and pssibly subject t the 20 percent penalty) if the HSA wner uses it t pay fr medical care that was btained befre the HSA existed. State law determines the exact HSA establishment date fr this purpse. Fr medical expenses incurred after an HSA is established, there is n time limit fr when an HSA wner may take a distributin. Similarly, HSA wners are nt bligated t take distributins at any time. All unused funds remain in an HSA frm year t year and may be used fr qualified medical expenses incurred in the future. Als, even if an HSA wner becmes ineligible t receive cntributins int an HSA, he r she may still use tax-free distributins frm an existing HSA t pay qualified medical expenses at any time, as lng as the expenses were incurred after the HSA establishment date. Fr example, an HSA wner wh nly qualifies t have cntributins made int an HSA in Year 1 may still use the HSA funds t pay qualified medical expenses that are incurred in Year 2 r later. $300 HSA funds cntributed in Year 1 (and HSA wner is n lnger eligible fr cntributins after Year 1) $50 Qualified incurred in Year 2 $50 Qualified incurred in Year 3 $50 Qualified incurred in Year 4 $150 balance may remain in HSA indefinitely 2
In additin, the mney used t pay a qualified medical expense des nt have t be in the HSA at the time the expense is incurred. Fr example, if an existing HSA has $1,000 and the HSA wner incurs $3,000 in medical expenses that year, he r she can pay the first $1,000 frm the current HSA funds and then wait fr future HSA cntributins t pay r reimburse him r herself fr the remaining $2,000. $1,000 cntributed t HSA in Year 1 $3,000 Qualified incurred in Year 1 $1,000 cntributed t HSA in Year 2 $1,000 cntributed t HSA in Year 3 WHO MAY BENEFIT FROM HSA DISTRIBUTIONS? HSA distributins are nt tax-free unless they are used t pay fr qualified medical expenses. These expenses d nt necessarily have t be incurred by the HSA wner. As lng as an expense is nt paid r reimbursed by any ther surce (such as the HDHP), an HSA distributin can als be used t pay qualified medical expenses incurred by the HSA wner s: Spuse (same-sex r ppsite-sex); Dependents whm the HSA wner claims n a tax return (including sme dmestic partners); and Dependents whm the HSA wner culd claim n a tax return, but: The persn filed a jint return; The persn had a grss incme f $3,950 r mre; r The HSA wner, r his r her spuse if filing jintly, culd have been claimed as a dependent n smene else s tax return. Fr this purpse, if parents f a child are divrced, separated r living apart fr the last six mnths f the calendar year, the child is treated as the dependent f bth parents regardless f which parent claims a child's exemptin. Als, it is imprtant t nte that dependents are defined differently fr HSA purpses than they are fr purpses f the Affrdable Care Act (ACA). While the ACA allws parents t keep their adult children n their health care plicies until age 26, the laws applicable t HSAs generally d nt nly allw HSA wners t pay fr their child s medical care after age 19 (age 24 if the dependent is a full-time student). HOW ARE HSA DISTRIBUTIONS TAXED? HSA distributins are exempt frm incme taxes if all f the funds are used t pay qualified medical expenses that were incurred after the HSA was established. If any prtin f a distributin is nt used fr qualified medical expenses, that prtin is taxable as incme and subject t a 20 percent penalty. Hwever, an HSA wner is nt subject t the 20 percent penalty n any HSA distributins that he r she takes after: Reaching age 65; r Becming disabled. 3
Thus, an HSA wner wh is ver age 65 r disabled may use distributins fr any purpse withut having t pay the 20 percent penalty, but any amunts that are nt used fr qualifying medical expenses are still subject t incme taxes. HSA wner is ver age 65 r disabled Ttal distributins minus Ttal amunt used fr qualified medical expenses = Ttal amunt taxable as incme HSA wner is under age 65 and nt disabled Ttal distributins minus Ttal amunt used fr qualified medical expenses = Ttal amunt taxable as incme and subject t 20 percent penalty After an HSA wner dies, tax treatment f HSA funds depends n whm the HSA wner designated t inherit the HSA. If the HSA wner s spuse is the designated beneficiary, the accunt becmes the spuse s HSA. This transfer f wnership is nt cnsidered a distributin; therefre, the funds are neither taxable nr subject t the 20 percent penalty when the spuse receives the accunt. If the HSA passes t anyne ther than the HSA wner s spuse, the accunt ceases t be an HSA and the 20 percent penalty n lnger applies. Hwever, the funds in the accunt becme taxable incme fr the beneficiary r the HSA wner s estate. If the deceased HSA wner incurred qualifying medical expenses befre death, the beneficiary r estate des nt have t pay incme taxes n the amunt f thse expenses as lng as they are paid within a year f the HSA wner s death. HOW ARE HSA DISTRIBUTIONS REPORTED? Emplyers are nt invlved in the reprting prcess fr HSA distributins. The HSA trustee r custdian tracks all HSA distributins and reprts them t the accunt wner and the IRS using IRS Frm 1099-SA. HSA wners reprt their distributins and medical expenses t the IRS using Frm 8889. They must keep their wn recrds f all payments made using HSA distributins, as they are slely respnsible fr substantiating all expenditures. If any prtin f the ttal distributins des nt meet all the requirements fr spending HSA funds, the HSA wner must include that prtin as taxable incme and, if applicable, pay the 20 percent penalty. WHAT IS A QUALIFIED MEDICAL EXPENSE? Fr HSA purpses, qualified medical expenses generally include the expenses listed in IRS Publicatin 502 fr the medical expenses tax deductin. The expenses must be incurred primarily t alleviate r prevent a physical r mental defect r illness. Expenses that are merely beneficial t general health, such as vitamins, are nt included. 4
Examples f Qualifying s Examples f n-qualifying s Addictin treatment Annual physical exams Ambulance services Artificial limbs Birth cntrl Cntact lenses Crutches Dental treatment Diagnstic devices Dctrs fees Eye exams Fertility enhancement Hearing aids Hme Care Hspital services Labratry fees Psychiatric care Special educatin Smking cessatin Wheelchairs Csmetic surgery Babysitting Dancing lessns Diaper services Hair transplants Health club dues Swimming lessns Teeth whitening Vacatin r travel Medicatin Fr HSA purpses, a medicine r drug is a nt a qualified medical expense unless it: Requires a prescriptin; Is available withut a prescriptin but has been prescribed; r Is insulin. Health Insurance Premiums In general, payments fr insurance are nt qualified medical expenses fr HSA purpses. Hwever, there are exceptins fr: Lng-term care cverage; Health care cverage fr an HSA wner wh has reached age 65; and Health care cverage during: Perids f cverage cntinuatin (such as under COBRA); and Perids during which an individual is receiving unemplyment cmpensatin under any federal r state law. WHAT ARE THE RESTRICTIONS AGAINST DOUBLE TAX ADVANTAGES? HSAs are designed t pay expenses that an HSA wner wuld therwise pay ut f pcket using after-tax incme. 5
Therefre, HSA funds cannt be used t pay expenses that any ther surce cvers r pays. Fr example, if the HSA wner s spuse has a separate health plan that reimburses him r her fr a certain expense, the HSA wner cannt use HSA funds t pay the expense and then later receive reimbursement frm the spuse s health plan. Similarly, an HSA wner cannt use HSA funds t reimburse an expense that he r she claimed as a medical expense deductin n a tax return. Fr example, if the HSA wner pays a medical expense ut f pcket and claims a medical expense deductin fr it in year 1, the HSA wner cannt take an HSA distributin t reimburse him r herself fr that expense in year 2 r any ther time. ARE THERE ANY OTHER TAX EXCEPTIONS FOR HSA DISTRIBUTIONS? Mistaken Distributins If an HSA wner withdraws mney t pay an expense that he r she reasnably, but mistakenly, believed t be a qualifying medical expense, he r she can avid tax cnsequences by returning the funds t the HSA befre April 15 f the year after he r she discvered the mistake. Rllvers HSA wners can mve funds frm ne HSA int anther withut tax cnsequences ne time per year. If an HSA wner withdraws HSA funds fr this purpse, he r she must depsit the funds int the new HSA within 60 days. Excess Cntributins If an HSA wner takes a distributin t crrect a vilatin f HSA cntributin limits, the amunt f the crrective distributin is nt taxed as incme. Hwever, the amunt f the excess cntributin must be included in the HSA wner s grss incme. Specific time limits and ther rules apply fr determining whether a distributin actually crrects an excess cntributin. PROHIBITED TRANSACTIONS Certain transactins can disqualify an HSA. Disqualificatin means that the accunt stps being an HSA and all f its funds immediately becme a taxable distributin subject t the 20 percent penalty. In general, prhibited transactins include anything that may cnstitute tax fraud, such as pledging an HSA as security fr a lan r selling assets t an HSA. MORE INFORMATION Fr mre infrmatin n HSAs, cntact yur representative at Haylr, Freyer & Cn, Inc.. 6