HSA, Archer MSA, or Medicare Advantage MSA Information

ICR 201806-1545-010

OMB: 1545-1518

Federal Form Document

Forms and Documents
IC Document Collections
IC ID
Document
Title
Status
18582 Modified
ICR Details
1545-1518 201806-1545-010
Active 201411-1545-053
TREAS/IRS
HSA, Archer MSA, or Medicare Advantage MSA Information
Extension without change of a currently approved collection   No
Regular
Approved without change 12/06/2018
Retrieve Notice of Action (NOA) 10/30/2018
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved 12/31/2018
9,167 0 9,167
1,559 0 1,559
0 0 0

Section 220(h) requires trustees to report to the IRS and medical savings account holders the contributions and year-end fair market value of any contributions made to a medical savings account (MSA). Congress requires Treasury to report to them the total contributions made to an MSA for the current tax year. Section 1201 of the Medicare prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173) created new Code section 223. Section 223(h) requires the reporting of contributions to and the year-end fair market value of health savings accounts for tax years beginning after December 31, 2003.

US Code: 26 USC 223 Name of Law: Health savings accounts
  
None

Not associated with rulemaking

  83 FR 12078 03/19/2018
83 FR 54653 10/30/2018
No

1
IC Title Form No. Form Name
HSA, Archer MSA, or Medicare Advantage MSA Information 5498-SA HSA, ARCHER MSA OR MEDICARE ADVANTAGE MSA INFORMATION

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 9,167 9,167 0 0 0 0
Annual Time Burden (Hours) 1,559 1,559 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$80,558
No
    No
    Yes
No
No
No
Uncollected
Melody Devoe 2022837635

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/30/2018


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