26 USC 4376 - Self-insured health plans

U.S Code last checked for updates: May 18, 2024

§ 4376.

Self-insured health plans

(a)

Imposition of fee

(b)

Liability for fee

(1)

In general

(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

(Added Pub. L. 111–148, title VI, § 6301(e)(2)(A), Mar. 23, 2010, 124 Stat. 744; amended Pub. L. 116–94, div. N, title I, § 104(c), Dec. 20, 2019, 133 Stat. 3098.)

cite as: 26 USC 4376