View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1545-1518
ICR Reference No:
202501-1545-001
Status:
Active
Previous ICR Reference No:
202108-1545-009
Agency/Subagency:
TREAS/IRS
Agency Tracking No:
Title:
HSA, Archer MSA, or Medicare Advantage MSA Information
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
05/06/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/31/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2028
36 Months From Approved
05/31/2025
Responses
38,473,400
0
9,167
Time Burden (Hours)
6,412,233
0
1,559
Cost Burden (Dollars)
0
0
0
Abstract:
Internal Revenue Code (IRC) Sections 138(e) and 220(h) requires trustees to report to the Internal Revenue Service (IRS) and medical savings accountholders contributions to and the year-end fair market value of any contributions made to an Archer or Medicare Advantage medical savings account (MSA). Congress requires Treasury to report to them the total contributions made to an MSA for the current tax year. IRC Section 223(h) requires the reporting of contributions to and the year-end fair market value of health savings accounts (HSA) for tax years beginning after December 31, 2003. Form 5498-SA, is used to report contributions to and rollovers into an Archer MSA, Medicare Advantage MSA, or HSA.
Authorizing Statute(s):
US Code:
26 USC 138
Name of Law: Medicare Advantage MSA
US Code:
26 USC 223
Name of Law: Health savings accounts
US Code:
26 USC 220
Name of Law: Archer Medical savings account
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
89 FR 78985
09/26/2024
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 14189
03/28/2025
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
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
ICR Summary of Burden
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
38,473,400
9,167
0
0
38,464,233
0
Annual Time Burden (Hours)
6,412,233
1,559
0
0
6,410,674
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
There is no change in the paperwork burden previously approved by OMB. However, the number of responses was updated based on current filing data. This increases the number of responses by 38,464,233 and the burden hours by 6,410,674 annually due to Agency Estimate.
Annual Cost to Federal Government:
$135,678
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Melody Devoe 2022837635
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
03/31/2025
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