azandyman is correct:
"The fee is not a medical expense but it is neither a distribution taxable to the recipient. "
If the custodian is UMB, when you call UMB, the response you're likely to receive is you need to call ConnectYourCare. When you call ConnectYourCare, they will tell you to call UMB. Do not fall for this trap! From the beginning, inform UMB the monthly maintenance fees are not a distribution, and you will not waste time making another phone call. Tell them to document this information for a supervisor, and you want a supervisor to call you back after they have corrected the 1099-SA. Also ask them when you can expect a call back.
The first time this happened to me, I wasted a lot of time calling UMB and ConnectYourCare because both refused to take ownership of the problem. The next time this happened, I sternly told UMB what they needed to do, and not to waste my time. I placed a call to UMB on a Wednesday, and was told I would get a call back within one business day. I got a call from a supervisor on Friday that they had issued a corrected 1099-SA with a gross distribution of zero.
