Understanding IRS Form 5498-SA

The Internal Revenue Service (IRS) requires Wells Fargo to issue IRS Form 5498-SA if you had any contribution activity in your Wells Fargo HSA during the previous tax year. We’ve provided a description of some of the fields on the form. Refer to Frequently Asked Questions for more information about HSA tax forms and filing.

Box 2 – Total contributions made in the previous tax year. This box contains the total contributions made in the previous tax year, including IRA to HSA transfers.

Box 3 – Total HSA or Archer MSA contributions made in 2013 for 2012.

Box 5 – Fair market value of HSA, Archer MSA, or MA MSA. This box contains the Fair Market Value (FMV) of the HSA at the end of the calendar year.

Box 6 – HSA, Archer MSA, MA MSA. This shows the type of account that is reported on this Form 5498-SA.


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All information provided here is intended as a convenient source of tax information. This information is general in nature, is not complete, and may not apply to your specific situation. You should consult your own tax advisor regarding your tax needs. Wells Fargo makes no warranties and is not responsible for your use of this information or for any errors or inaccuracies resulting from your use.

Archer MSA

Archer Medical Savings Accounts (MSAs) were established in 1997 and number among the IRS tax-favored health accounts, which include Health Savings Accounts, Flexible Spending Arrangements, and Health Reimbursement Arrangements.