Trustee or custodian
Name, employer identification number, street address, city, state and ZIP code, and telephone number.
8851
Summary of Archer MSAs
- Agency
- IRS
- Revision
- Rev. February 2007
- Fillable fields
- 93
- Pages
- 2
- Official source
- IRS form page
- Checked
- October 21, 2026
Form 8851: Summary of Archer MSAs
Form 8851, Summary of Archer MSAs, is filed by the trustee or custodian of Archer medical savings accounts, not by account holders. The IRS says trustees and custodians use it to report the total number of Archer MSAs they established, the total number of previously uninsured account holders, the total number of excludable account holders, and the names and Social Security numbers of account holders.
The form says the report is used to furnish information about Archer MSAs to Congress and to determine when the maximum number of Archer MSAs allowed by law (750,000, excluding previously uninsured account holders) is reached. The February 2007 revision covers MSAs established from January 1 through June 30 of 2005 and of 2006.
You can fill out Form 8851 free in your browser on this page and download the result without an account.
What's on Form 8851
Line a: reporting period
Two boxes for a report covering January 1 through June 30, 2005, or January 1 through June 30, 2006.
Box b: number of Archer MSAs
The total number of Archer MSAs established during the period covered by the form.
Boxes c and d: account holder counts
The total number of previously uninsured account holders and the total number of excludable account holders.
Lines 1 to 20: account holders
Each account holder's name and Social Security number, with boxes to check if previously uninsured or excludable.
How to fill out Form 8851
- 1
Trustee information
Enter the trustee's or custodian's name, EIN, address and telephone number.
- 2
Line a
Check the reporting period. The form says a separate Form 8851 is filed for each reporting period.
- 3
Box b
Count all Archer MSAs opened in the period, including those for previously uninsured or excludable holders. Leave out Medicare Advantage MSAs, rollovers from another Archer MSA, MSAs set up after June 30, and MSAs set up in the period for the prior year.
- 4
Box c
Enter the number of previously uninsured holders. The instructions define them by having no health plan coverage during the 6-month period before high deductible health plan coverage began, with coverage not beginning before July 1, 1996.
- 5
Box d
Enter the number of excludable holders. The instructions say a holder can't be both previously uninsured and excludable, so a holder counted in box c is not counted in box d.
- 6
Lines 1 to 20
Enter each holder's name and SSN and check the previously uninsured or excludable box if one applies, never both. Attach additional sheets if necessary.
Why fill Form 8851 on indox
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When, how and where to file
Deadline printed on the form
The form says to file a separate Form 8851 for each reporting period by March 20, 2007, for Archer MSAs established from January 1 through June 30 of 2005 and of 2006.
Electronic or paper
The form says fewer than 250 Archer MSAs may be reported on paper, though electronic filing is strongly encouraged, and larger reports are filed electronically. It points to Announcement 2007-15.
Electronic filing help
For information on filing electronically, the form gives the toll-free number 1-866-455-7438. Electronic filers complete the trustee information above line a and transmit it to the IRS or fax it to 304-264-5602.
Where to send it
IRS-Enterprise Computing Center, Martinsburg, Information Reporting Program, Attn: 8851 Coordinator, 240 Murall Drive, Kearneysville, WV 25430.
Related forms
Who files Form 8851?
The form says to file it if you are the trustee or custodian of an Archer MSA. The completed form goes to the IRS.
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Questions about Form 8851
Who files Form 8851?
The trustee or custodian of an Archer MSA. The form says that can be a bank or similar financial institution, an insurance company, or another person approved by the IRS as an IRA trustee or custodian.
Do Archer MSA account holders file Form 8851?
No. The trustee or custodian files it and lists each account holder's name and Social Security number.
What periods does this revision cover?
January 1 through June 30, 2005, and January 1 through June 30, 2006. The form says a separate Form 8851 is filed for each reporting period.
What is the report used for?
The form says it furnishes information about Archer MSAs to Congress and is used to determine when the maximum number allowed by law (750,000, excluding previously uninsured account holders) is reached.
Can an account holder be both previously uninsured and excludable?
No. The instructions say not to check both boxes for one account holder, and a holder counted in box c is not counted in box d.
Are Medicare Advantage MSAs included?
No. The instructions for box b say not to include Medicare Advantage MSAs or Archer MSAs set up by a rollover from another Archer MSA.