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Internal Revenue Bulletin:  2004-3 

January 20, 2004 

Announcement 2004-2

New Code W for the 2004 Form W-2, Box 12

Table of Contents

Purpose The purpose of this announcement is to advise employers about an additional code for use on the 2004 Form W-2. This code will be used to identify the amount of an employer’s contribution to an employee’s Health Savings Account (HSA).
Health SavingsAccounts(HSA) A new code (Code W—Employer’s contribution to an employee’s Health Savings Account (HSA)) for use in box 12 on the 2004 Form W-2 has been added to the 2004 Instructions for Forms W-2 and W-3.
  The Medicare Prescription Drug Improvement and Modernization Act of 2003 requires reporting of an employer’s contributions to an employee’s HSA on Form W-2. The amount that an employer contributes to an employee’s HSA will be shown in box 12 of Form W-2, using Code W.
  Generally, employer contributions to an employee’s MSA are not subject to income, social security/Medicare, or Railroad Retirement taxes and will not affect amounts otherwise reported in boxes 1, 3, and 5 of Form W-2.

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