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Text of IRS Instructions for 2015 Form 8853: Archer MSAs and Long-Term Care Insurance Contract (PDF)
Internal Revenue Service [IRS] 
[Official Guidance] Dec. 9, 2015
"Use Form 8853 to: [1] Report Archer MSA contributions (including employer contributions), [2] Figure your Archer MSA deduction, [3] Report distributions from Archer MSAs or Medicare Advantage MSAs, [4] Report taxable payments from long-term care (LTC) insurance contracts, or [5] Report taxable accelerated death benefits from a life insurance policy."
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