26-U.S.C.-4376

26-U.S.C.-4376

§4376 – Self-Insured Health Plans

Pathway

Title 26 > Subtitle D > Chapter 34 > Subchapter B > Section 4376

Details

  • Reference: Section 4376
  • Legend: §4376 – Self-Insured Health Plans
  • USCode Year: 2013

Provision Content

(a) Imposition of fee

In the case of any applicable self-insured health plan for each plan year ending after September 30, 2012, there is hereby imposed a fee equal to $2 ($1 in the case of plan years ending during fiscal year 2013) multiplied by the average number of lives covered under the plan.

(b) Liability for fee

(1) In general

The fee imposed by subsection (a) shall be paid by the plan sponsor.

(2) Plan sponsor

For purposes of paragraph (1) the term plan sponsor means—

(A) the employer in the case of a plan established or maintained by a single employer,

(B) the employee organization in the case of a plan established or maintained by an employee organization,

(C) in the case of—

(i) a plan established or maintained by 2 or more employers or jointly by 1 or more employers and 1 or more employee organizations,

(ii) a multiple employer welfare arrangement, or

(iii) a voluntary employees’ beneficiary association described in section 501(c)(9), the association, committee, joint board of trustees, or other similar group of representatives of the parties who establish or maintain the plan, or

(D) the cooperative or association described in subsection (c)(2)(F) in the case of a plan established or maintained by such a cooperative or association.

(c) Applicable self-insured health plan

For purposes of this section, the term applicable self-insured health plan means any plan for providing accident or health coverage if—

(1) any portion of such coverage is provided other than through an insurance policy, and

(2) such plan is established or maintained—

(A) by 1 or more employers for the benefit of their employees or former employees,

(B) by 1 or more employee organizations for the benefit of their members or former members,

(C) jointly by 1 or more employers and 1 or more employee organizations for the benefit of employees or former employees,

(D) by a voluntary employees’ beneficiary association described in section 501(c)(9),

(E) by any organization described in section 501(c)(6), or

(F) in the case of a plan not described in the preceding subparagraphs, by a multiple employer welfare arrangement (as defined in section 3(40) of Employee Retirement Income Security Act of 1974), a rural electric cooperative (as defined in section 3(40)(B)(iv) of such Act), or a rural telephone cooperative association (as defined in section 3(40)(B)(v) of such Act).

(d) Adjustments for increases in health care spending

In the case of any plan year ending in any fiscal year beginning after September 30, 2014, the dollar amount in effect under subsection (a) for such plan year shall be equal to the sum of such dollar amount for plan years ending in the previous fiscal year (determined after the application of this subsection), plus an amount equal to the product of—

(1) such dollar amount for plan years ending in the previous fiscal year, multiplied by

(2) the percentage increase in the projected per capita amount of National Health Expenditures, as most recently published by the Secretary before the beginning of the fiscal year.

(e) Termination

This section shall not apply to plan years ending after September 30, 2019.

(Added Pub. L. 111–148, title VI, §6301(e)(2)(A), Mar. 23, 2010, 124 Stat. 744.)

References in Text

Section 3(40) of Employee Retirement Income Security Act of 1974, referred to in subsec. (c)(2)(F), is classified to section 1002(40) of Title 29, Labor.

U.S. Encyclopedia of Law Coverage

26-U.S.C.-4283 in the Legal Encyclopedia: Taxes

In this entry about 26-U.S.C.-4283, find legal reference material, bibliographies and premiere content related to taxes in the American Encyclopedia of Law, presenting a comprehensive view of the United States taxes-specific issues, written by authorities in the field.

26-U.S.C.-4375 in the Legal Encyclopedia: Insurance

In this entry about 26-U.S.C.-4375, find legal reference material, bibliographies and premiere content related to insurance in the American Encyclopedia of Law, presenting a comprehensive view of the United States insurance-specific issues, written by authorities in the field.

25-U.S.C.-1680L in the Legal Encyclopedia: Health Care

In this entry about 25-U.S.C.-1680L, find legal reference material, bibliographies and premiere content related to health care in the American Encyclopedia of Law, presenting a comprehensive view of the United States health care-specific issues, written by authorities in the field.

Topic Map


Posted

in

,

by

Comments

Leave a Reply

Your email address will not be published. Required fields are marked *