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U.S.C.
Notes

§101. Certain death benefits — Inbound Citations

26 U.S.C. § 101

Cited by 1941 provisions in release 119-102.

Citations to 26 U.S.C. § 101 as a whole

Citations to §101(a)(3)(B)

Citations to §101(f)

Citations to §101(f)(2)(C)

Citations to §101(f)(3)(A)

Citations to §101(f)(3)(B)

Citations to §101(f)(3)(C)

Citations to §101(g)

Citations to §101(g)(3)

Citations to §101(g)(4)(A)

Citations to §101(g)(4)(B)

Citations to §101(g)(4)(C)

Citations to §101(g)(4)(D)

Citations to §101(i)(3)

  • 26 U.S.C. § 2039(b)
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    (b) Subsection (a) shall apply to only such part of the value of the annuity or other payment receivable under such contract or agreement as is proportionate to that part of the purchase price therefor contributed by the decedent. For purposes of this section, any contribution by the decedent’s employer or former employer to the purchase price of such contract or agreement (whether or not to an employee’s trust or fund forming part of a pension, annuity, retirement, bonus or profit sharing plan) shall be considered to be contributed by the decedent if made by reason of his employment.
  • 26 U.S.C. § 2055(a)(5)
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    (5) to an employee stock ownership plan if such transfer qualifies as a qualified gratuitous transfer of qualified employer securities within the meaning of section 664(g).
  • 26 U.S.C. § 2056(b)(8)(B)(ii)
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    (ii) The term “ESOP beneficiary” means any beneficiary which is an employee stock ownership plan (as defined in section 4975(e)(7)) that holds a remainder interest in qualified employer securities (as defined in section 664(g)(4)) to be transferred to such plan in a qualified gratuitous transfer (as defined in section 664(g)(1)).
  • 26 U.S.C. § 4103(1)
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    (1) who is an officer, employee, or agent of the taxpayer who is under a duty to assure the payment of such tax and who willfully fails to perform such duty, or
  • 26 U.S.C. § 4221(d)(7)(C)
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    (C) The term “school bus” means any automobile bus substantially all the use of which is in transporting students and employees of schools. For purposes of the preceding sentence, the term “school” means an educational organization which normally maintains a regular faculty and curriculum and normally has a regularly enrolled body of pupils or students in attendance at the place where its educational activities are carried on.
  • 26 U.S.C. § 4376(b)(2)(B)
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    (B) the employee organization in the case of a plan established or maintained by an employee organization,
  • 26 U.S.C. § 4376(b)(2)(C)(i)
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    (i) a plan established or maintained by 2 or more employers or jointly by 1 or more employers and 1 or more employee organizations,
  • 26 U.S.C. § 4376(b)(2)(C)(iii)
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    (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
  • 26 U.S.C. § 4376(c)(2)(A)
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    (A) by 1 or more employers for the benefit of their employees or former employees,
  • 26 U.S.C. § 4376(c)(2)(B)
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    (B) by 1 or more employee organizations for the benefit of their members or former members,
  • 26 U.S.C. § 4376(c)(2)(C)
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    (C) jointly by 1 or more employers and 1 or more employee organizations for the benefit of employees or former employees,
  • 26 U.S.C. § 4376(c)(2)(D)
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    (D) by a voluntary employees’ beneficiary association described in section 501(c)(9),
  • 26 U.S.C. § 4376(c)(2)(F)
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    (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).
  • 26 U.S.C. § 4402(3)
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    (3) On any wager placed in a sweepstakes, wagering pool, or lottery which is conducted by an agency of a State acting under authority of State law, but only if such wager is placed with the State agency conducting such sweepstakes, wagering pool, or lottery, or with its authorized employees or agents.
  • 26 U.S.C. § 4424(a)
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    (a) Except as otherwise provided in this section, neither the Secretary nor any other officer or employee of the Treasury Department may divulge or make known in any manner whatever to any person—
    (1) any original, copy, or abstract of any return, payment, or registration made pursuant to this chapter,
    (2) any record required for making any such return, payment, or registration, which the Secretary is permitted by the taxpayer to examine or which is produced pursuant to section 7602, or
    (3) any information come at by the exploitation of any such return, payment, registration, or record.
  • 26 U.S.C. § 4424(b)(1)
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    (1) divulged or made known in any manner whatever by any officer or employee of the United States to any person except in connection with the administration or civil or criminal enforcement of this title, nor
  • 26 U.S.C. § 4501(c)(3)
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    (3) The amount taken into account under subsection (a) with respect to any stock repurchased by a covered corporation shall be reduced by the fair market value of any stock issued by the covered corporation during the taxable year, including the fair market value of any stock issued or provided to employees of such covered corporation or employees of a specified affiliate of such covered corporation during the taxable year, whether or not such stock is issued or provided in response to the exercise of an option to purchase such stock.
  • 26 U.S.C. § 4501(d)(1)(C)
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    (C) the adjustment under subsection (c)(3) shall be determined only with respect to stock issued or provided by such specified affiliate to employees of the specified affiliate.
  • 26 U.S.C. § 4501(d)(2)(C)
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    (C) the adjustment under subsection (c)(3) shall be determined only with respect to stock issued or provided by such expatriated entity to employees of the expatriated entity.
  • 26 U.S.C. § 4501(e)(2)
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    (2) in any case in which the stock repurchased is, or an amount of stock equal to the value of the stock repurchased is, contributed to an employer-sponsored retirement plan, employee stock ownership plan, or similar plan,
  • 26 U.S.C. § 4911(d)(1)(B)
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    (B) any attempt to influence any legislation through communication with any member or employee of a legislative body, or with any government official or employee who may participate in the formulation of the legislation.
  • 26 U.S.C. § 4911(d)(2)(E)
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    (E) any communication with a governmental official or employee, other than—
    (i) a communication with a member or employee of a legislative body (where such communication would otherwise constitute the influencing of legislation), or
    (ii) a communication the principal purpose of which is to influence legislation.
  • 26 U.S.C. § 4911(d)(2)(E)(i)
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    (i) a communication with a member or employee of a legislative body (where such communication would otherwise constitute the influencing of legislation), or
  • 26 U.S.C. § 4941(d)(2)(G)(vii)
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    (vii) any payment or reimbursement of traveling expenses for travel solely from one point in the United States to another point in the United States, but only if such payment or reimbursement does not exceed the actual cost of the transportation involved plus an amount for all other traveling expenses not in excess of 125 percent of the maximum amount payable under section 5702 of title 5, United States Code, for like travel by employees of the United States; and
  • 26 U.S.C. § 4943(g)(4)(A)
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    (A) no substantial contributor (as defined in section 4958(c)(3)(C)) to the private foundation or family member (as determined under section 4958(f)(4)) of such a contributor is a director, officer, trustee, manager, employee, or contractor of the business enterprise (or an individual having powers or responsibilities similar to any of the foregoing),
  • 26 U.S.C. § 4945(e)(2)
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    (2) any attempt to influence legislation through communication with any member or employee of a legislative body, or with any other government official or employee who may participate in the formulation of the legislation (except technical advice or assistance provided to a governmental body or to a committee or other subdivision thereof in response to a written request by such body or subdivision, as the case may be),
  • 26 U.S.C. § 4946(b)(2)
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    (2) with respect to any act (or failure to act), the employees of the foundation having authority or responsibility with respect to such act (or failure to act).
  • 26 U.S.C. § 4946(c)
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    (c) For purposes of subsection (a)(1)(I) and section 4941, the term “government official” means, with respect to an act of self-dealing described in section 4941, an individual who, at the time of such act, holds any of the following offices or positions (other than as a “special Government employee”, as defined in section 202(a) of title 18, United States Code):
    (1) an elective public office in the executive or legislative branch of the Government of the United States,
    (2) an office in the executive or judicial branch of the Government of the United States, appointment to which was made by the President,
    (3) a position in the executive, legislative, or judicial branch of the Government of the United States—
    (A) which is listed in schedule C of rule VI of the Civil Service Rules, or
    (B) the compensation for which is equal to or greater than the lowest rate of basic pay for the Senior Executive Service under section 5382 of title 5, United States Code,
    (4) a position under the House of Representatives or the Senate of the United States held by an individual receiving gross compensation at an annual rate of $15,000 or more,
    (5) an elective or appointive public office in the executive, legislative, or judicial branch of the government of a State, possession of the United States, or political subdivision or other area of any of the foregoing, or of the District of Columbia, held by an individual receiving gross compensation at an annual rate of $20,000 or more,
    (6) a position as personal or executive assistant or secretary to any of the foregoing, or
    (7) a member of the Internal Revenue Service Oversight Board.
  • 26 U.S.C. § 4947(b)(4)
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    (4) The provisions of section 507(a) shall not apply to a trust which is described in subsection (a)(2) by reason of a distribution of qualified employer securities (as defined in section 664(g)(4)) to an employee stock ownership plan (as defined in section 4975(e)(7)) in a qualified gratuitous transfer (as defined by section 664(g)).
  • 26 U.S.C. § 4951(e)(4)(D)
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    (D) an officer, director, or employee of a person who is a contributor to the trust,
  • 26 U.S.C. § 4955(f)(2)(B)
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    (B) with respect to any expenditure, any employee of the organization having authority or responsibility with respect to such expenditure.
  • 26 U.S.C. § 4958(f)(8)(B)
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    (B) For purposes of subparagraph (A), the term “investment advisor” means, with respect to any sponsoring organization (as defined in section 4966(d)(1)), any person (other than an employee of such organization) compensated by such organization for managing the investment of, or providing investment advice with respect to, assets maintained in donor advised funds (as defined in section 4966(d)(2)) owned by such organization.
  • 26 U.S.C. § 4960(a)(1)
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    (1) so much of the remuneration paid (other than any excess parachute payment) by an applicable tax-exempt organization for the taxable year with respect to employment of any covered employee in excess of $1,000,000, plus
  • 26 U.S.C. § 4960(a)(2)
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    (2) any excess parachute payment paid by such an organization to any covered employee.
  • 26 U.S.C. § 4960(c)(2)
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    (2) For purposes of this section, the term “covered employee” means any employee of an applicable tax-exempt organization (or any predecessor of such an organization) and any former employee of such an organization (or predecessor) who was such an employee during any taxable year beginning after December 31, 2016.
  • 26 U.S.C. § 4960(c)(4)(A)
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    (A) Remuneration of a covered employee by an applicable tax-exempt organization shall include any remuneration paid with respect to employment of such employee by any related person or governmental entity.
  • 26 U.S.C. § 4960(c)(4)(B)(v)
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    (v) in the case of an organization which is a voluntary employees’ beneficiary association described in section 501(c)(9), establishes, maintains, or makes contributions to such voluntary employees’ beneficiary association.
  • 26 U.S.C. § 4960(c)(4)(C)(i)
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    (i) the amount of remuneration paid by such employer with respect to such employee, bears to
  • 26 U.S.C. § 4960(c)(4)(C)(ii)
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    (ii) the amount of remuneration paid by all such employers to such employee.
  • 26 U.S.C. § 4960(c)(5)(B)
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    (B) The term “parachute payment” means any payment in the nature of compensation to (or for the benefit of) a covered employee if—
    (i) such payment is contingent on such employee’s separation from employment with the employer, and
    (ii) the aggregate present value of the payments in the nature of compensation to (or for the benefit of) such individual which are contingent on such separation equals or exceeds an amount equal to 3 times the base amount.
  • 26 U.S.C. § 4960(c)(5)(B)(i)
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    (i) such payment is contingent on such employee’s separation from employment with the employer, and
  • 26 U.S.C. § 4960(c)(5)(C)(iv)
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    (iv) to an individual who is not a highly compensated employee as defined in section 414(q).
  • 26 U.S.C. § 4960(d)
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    (d) The Secretary shall prescribe such regulations as may be necessary to prevent avoidance of the tax under this section, including regulations to prevent avoidance of such tax through the performance of services other than as an employee or by providing compensation through a pass-through or other entity to avoid such tax.
  • 26 U.S.C. § 4966(d)(3)(B)
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    (B) with respect to any act (or failure to act), the employees of the sponsoring organization having authority or responsibility with respect to such act (or failure to act).
  • 26 U.S.C. § 4971(i)
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    (i) For disallowance of deduction for taxes paid under this section, see section 275.
    For liability for tax in case of an employer party to collective bargaining agreement, see section 413(b)(6).
    For provisions concerning notification of Secretary of Labor of imposition of tax under this section, waiver of the tax imposed by subsection (b), and other coordination between Secretary of the Treasury and Secretary of Labor with respect to compliance with this section, see section 3002(b) of title III of the Employee Retirement Income Security Act of 1974.
  • 26 U.S.C. § 4972(c)(4)(A)
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    (A) the amount which is required to be contributed to a plan under section 412 on behalf of an individual who is an employee (within the meaning of section 401(c)(1)), exceeds
  • 26 U.S.C. § 4972(c)(6)(B)
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    (B) so much of the contributions to a simple retirement account (within the meaning of section 408(p)), a simple plan (within the meaning of section 401(k)(11)), or a simplified employee pension (within the meaning of section 408(k)) which are not deductible when contributed solely because such contributions are not made in connection with a trade or business of the employer.
  • 26 U.S.C. § 4972(d)(1)(A)(iii)
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    (iii) any simplified employee pension (within the meaning of section 408(k)), and
  • 26 U.S.C. § 4972(d)(2)
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    (2) In the case of a plan which provides contributions or benefits for employees some or all of whom are self-employed individuals within the meaning of section 401(c)(1), the term “employer” means the person treated as the employer under section 401(c)(4).
  • 26 U.S.C. § 4975(c)(2)
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    (2) The Secretary shall establish an exemption procedure for purposes of this subsection. Pursuant to such procedure, he may grant a conditional or unconditional exemption of any disqualified person or transaction, orders of disqualified persons or transactions, from all or part of the restrictions imposed by paragraph (1) of this subsection. Action under this subparagraph may be taken only after consultation and coordination with the Secretary of Labor. The Secretary may not grant an exemption under this paragraph unless he finds that such exemption is—
    (A) administratively feasible,
    (B) in the interests of the plan and of its participants and beneficiaries, and
    (C) protective of the rights of participants and beneficiaries of the plan.
    Before granting an exemption under this paragraph, the Secretary shall require adequate notice to be given to interested persons and shall publish notice in the Federal Register of the pendency of such exemption and shall afford interested persons an opportunity to present views. No exemption may be granted under this paragraph with respect to a transaction described in subparagraph (E) or (F) of paragraph (1) unless the Secretary affords an opportunity for a hearing and makes a determination on the record with respect to the findings required under subparagraphs (A), (B), and (C) of this paragraph, except that in lieu of such hearing the Secretary may accept any record made by the Secretary of Labor with respect to an application for exemption under section 408(a) of title I of the Employee Retirement Income Security Act of 1974.
  • 26 U.S.C. § 4975(c)(7)
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    (7) Any party to an arrangement which satisfies the requirements of section 408(h) of the Employee Retirement Income Security Act of 1974 shall be exempt from the tax imposed by this section with respect to such arrangement.
  • 26 U.S.C. § 4975(d)(1)(B)
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    (B) is not made available to highly compensated employees (within the meaning of section 414(q)) in an amount greater than the amount made available to other employees,
  • 26 U.S.C. § 4975(d)(3)
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    (3) any loan to a leveraged employee stock ownership plan (as defined in subsection (e)(7)), if—
    (A) such loan is primarily for the benefit of participants and beneficiaries of the plan, and
    (B) such loan is at a reasonable rate of interest, and any collateral which is given to a disqualified person by the plan consists only of qualifying employer securities (as defined in subsection (e)(8));
  • 26 U.S.C. § 4975(d)(4)(A)
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    (A) the plan covers only employees of such bank or other institution and employees of affiliates of such bank or other institution, or
  • 26 U.S.C. § 4975(d)(6)(B)(ii)
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    (ii) in a manner that would be inconsistent with the best interests of participants and beneficiaries of employee benefit plans;
  • 26 U.S.C. § 4975(d)(10)
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    (10) receipt by a disqualified person of any reasonable compensation for services rendered, or for the reimbursement of expenses properly and actually incurred, in the performance of his duties with the plan, but no person so serving who already receives full-time pay from an employer or an association of employers, whose employees are participants in the plan or from an employee organization whose members are participants in such plan shall receive compensation from such fund, except for reimbursement of expenses properly and actually incurred;
  • 26 U.S.C. § 4975(d)(11)
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    (11) service by a disqualified person as a fiduciary in addition to being an officer, employee, agent, or other representative of a disqualified person;
  • 26 U.S.C. § 4975(d)(12)
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    (12) the making by a fiduciary of a distribution of the assets of the trust in accordance with the terms of the plan if such assets are distributed in the same manner as provided under section 4044 of title IV of the Employee Retirement Income Security Act of 1974 (relating to allocation of assets);
  • 26 U.S.C. § 4975(d)(14)
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    (14) any transaction required or permitted under part 1 of subtitle E of title IV or section 4223 of the Employee Retirement Income Security Act of 1974, but this paragraph shall not apply with respect to the application of subsection (c)(1) (E) or (F);
  • 26 U.S.C. § 4975(d)(17)(A)(iii)
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    (iii) the direct or indirect receipt of fees or other compensation by the fiduciary adviser or an affiliate thereof (or any employee, agent, or registered representative of the fiduciary adviser or affiliate) in connection with the provision of the advice or in connection with an acquisition, holding, or sale of a security or other property available as an investment under the plan pursuant to the investment advice; and
  • 26 U.S.C. § 4975(d)(22)(E)
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    (E) each plan participating in the transaction has assets of at least $100,000,000, except that if the assets of a plan are invested in a master trust containing the assets of plans maintained by employers in the same controlled group (as defined in section 407(d)(7) of the Employee Retirement Income Security Act of 1974), the master trust has assets of at least $100,000,000,
  • 26 U.S.C. § 4975(e)(2)(C)
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    (C) an employer any of whose employees are covered by the plan;
  • 26 U.S.C. § 4975(e)(2)(D)
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    (D) an employee organization any of whose members are covered by the plan;
  • 26 U.S.C. § 4975(e)(2)(E)
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    (E) an owner, direct or indirect, of 50 percent or more of—
    (i) the combined voting power of all classes of stock entitled to vote or the total value of shares of all classes of stock of a corporation,
    (ii) the capital interest or the profits interest of a partnership, or
    (iii) the beneficial interest of a trust or unincorporated enterprise,
    which is an employer or an employee organization described in subparagraph (C) or (D);
  • 26 U.S.C. § 4975(e)(2)(H)
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    (H) an officer, director (or an individual having powers or responsibilities similar to those of officers or directors), a 10 percent or more shareholder, or a highly compensated employee (earning 10 percent or more of the yearly wages of an employer) of a person described in subparagraph (C), (D), (E), or (G); or
  • 26 U.S.C. § 4975(e)(3)
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    (3) For purposes of this section, the term “fiduciary” means any person who—
    (A) exercises any discretionary authority or discretionary control respecting management of such plan or exercises any authority or control respecting management or disposition of its assets,
    (B) renders investment advice for a fee or other compensation, direct or indirect, with respect to any moneys or other property of such plan, or has any authority or responsibility to do so, or
    (C) has any discretionary authority or discretionary responsibility in the administration of such plan.
    Such term includes any person designated under section 405(c)(1)(B) of the Employee Retirement Income Security Act of 1974.
  • 26 U.S.C. § 4975(e)(7)
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    (7) The term “employee stock ownership plan” means a defined contribution plan—
    (A) which is a stock bonus plan which is qualified, or a stock bonus and a money purchase plan both of which are qualified under section 401(a), and which are designed to invest primarily in qualifying employer securities; and
    (B) which is otherwise defined in regulations prescribed by the Secretary.
    A plan shall not be treated as an employee stock ownership plan unless it meets the requirements of section 409(h), section 409(o), and, if applicable, section 409(n), section 409(p), and section 664(g) and, if the employer has a registration-type class of securities (as defined in section 409(e)(4)), it meets the requirements of section 409(e).
  • 26 U.S.C. § 4975(e)(8)
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    (8) The term “qualifying employer security” means any employer security within the meaning of section 409(l). If any moneys or other property of a plan are invested in shares of an investment company registered under the Investment Company Act of 1940, the investment shall not cause that investment company or that investment company’s investment adviser or principal underwriter to be treated as a fiduciary or a disqualified person for purposes of this section, except when an investment company or its investment adviser or principal underwriter acts in connection with a plan covering employees of the investment company, its investment adviser, or its principal underwriter.
  • 26 U.S.C. § 4975(e)(9)(B)
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    (B) In the case of any trust to which this section applies by reason of subparagraph (A), the term “disqualified person” includes any person who is a disqualified person with respect to any plan to which such trust is permitted to make payments under section 4223 of the Employee Retirement Income Security Act of 1974.
  • 26 U.S.C. § 4975(f)(6)(A)
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    (A) In the case of a trust described in section 401(a) which is part of a plan providing contributions or benefits for employees some or all of whom are owner-employees (as defined in section 401(c)(3)), the exemptions provided by subsection (d) (other than paragraphs (9) and (12)) shall not apply to a transaction in which the plan directly or indirectly—
    (i) lends any part of the corpus or income of the plan to,
    (ii) pays any compensation for personal services rendered to the plan to, or
    (iii) acquires for the plan any property from, or sells any property to,
    any such owner-employee, a member of the family (as defined in section 267(c)(4)) of any such owner-employee, or any corporation in which any such owner-employee owns, directly or indirectly, 50 percent or more of the total combined voting power of all classes of stock entitled to vote or 50 percent or more of the total value of shares of all classes of stock of the corporation.
  • 26 U.S.C. § 4975(f)(6)(B)(i)
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    (i) For purposes of subparagraph (A), the following shall be treated as owner-employees:
    (I) A shareholder-employee.
    (II) A participant or beneficiary of an individual retirement plan (as defined in section 7701(a)(37)).
    (III) An employer or association of employees which establishes such an individual retirement plan under section 408(c).
  • 26 U.S.C. § 4975(f)(6)(B)(i)(I)
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    (I) A shareholder-employee.
  • 26 U.S.C. § 4975(f)(6)(B)(i)(III)
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    (III) An employer or association of employees which establishes such an individual retirement plan under section 408(c).
  • 26 U.S.C. § 4975(f)(6)(B)(ii)
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    (ii) Subparagraph (A)(iii) shall not apply to a transaction which consists of a sale of employer securities to an employee stock ownership plan (as defined in subsection (e)(7)) by a shareholder-employee, a member of the family (as defined in section 267(c)(4)) of such shareholder-employee, or a corporation in which such a shareholder-employee owns stock representing a 50 percent or greater interest described in subparagraph (A).
  • 26 U.S.C. § 4975(f)(6)(B)(iii)
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    (iii) For purposes of subparagraph (A)(i), the term “owner-employee” shall only include a person described in subclause (II) or (III) of clause (i).
  • 26 U.S.C. § 4975(f)(6)(C)
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    (C) For purposes of subparagraph (B), the term “shareholder-employee” means an employee or officer of an S corporation who owns (or is considered as owning within the meaning of section 318(a)(1)) more than 5 percent of the outstanding stock of the corporation on any day during the taxable year of such corporation.
  • 26 U.S.C. § 4975(f)(8)(C)(iii)(III)
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    (III) The term “eligible investment expert” means any person which meets such requirements as the Secretary of Labor may provide and which does not bear any material affiliation or contractual relationship with any investment adviser or a related person thereof (or any employee, agent, or registered representative of the investment adviser or related person).
  • 26 U.S.C. § 4975(f)(8)(J)(i)(VI)
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    (VI) an employee, agent, or registered representative of a person described in subclauses (I) through (V) who satisfies the requirements of applicable insurance, banking, and securities laws relating to the provision of the advice.
  • 26 U.S.C. § 4975(f)(11)(B)(i)
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    (i) Subsection (d)(23) does not apply to any transaction between a plan and a plan sponsor or its affiliates that involves the acquisition or sale of an employer security (as defined in section 407(d)(1) of the Employee Retirement Income Security Act of 1974) or the acquisition, sale, or lease of employer real property (as defined in section 407(d)(2) of such Act).
  • 26 U.S.C. § 4975(f)(12)(B)(xi)(I)
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    (I) An automatic portability provider shall, for not less than 6 years after the automatic portability transaction has occurred, maintain the records sufficient to demonstrate the terms of this subparagraph have been met. The automatic portability provider shall make such records available to any authorized employee of the Department of the Treasury or the Department of Labor within 30 calendar days of the date of a written request for such records.
  • 26 U.S.C. § 4975(g)(1)
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    (1) in the case of a plan to which a guaranteed benefit policy (as defined in section 401(b)(2)(B) of the Employee Retirement Income Security Act of 1974) is issued, to any assets of the insurance company, insurance service, or insurance organization merely because of its issuance of such policy;
  • 26 U.S.C. § 4975(i)
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    (i) For provisions concerning coordination procedures between Secretary of Labor and Secretary of the Treasury with respect to application of tax imposed by this section and for authority to waive imposition of the tax imposed by subsection (b), see section 3003 of the Employee Retirement Income Security Act of 1974.
  • 26 U.S.C. § 4976(b)(1)(A)
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    (A) any post-retirement medical benefit or life insurance benefit provided with respect to a key employee if a separate account is required to be established for such employee under section 419A(d) and such payment is not from such account,
  • 26 U.S.C. § 4976(b)(2)
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    (2) Paragraph (1)(B) shall not apply to any plan maintained pursuant to an agreement between employee representatives and 1 or more employers if the Secretary finds that such agreement is a collective bargaining agreement and that the benefits referred to in paragraph (1)(B) were the subject of good faith bargaining between such employee representatives and such employer or employers.
  • 26 U.S.C. § 4977(b)(2)(A)
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    (A) which was paid by the employer during such calendar year to employees, and
  • 26 U.S.C. § 4977(c)
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    (c) If—
    (1) an election under this section is in effect with respect to an employer for any calendar year, and
    (2) at all times on or after January 1, 1984, and before the close of the calendar year involved, substantially all of the employees of the employer were entitled to employee discounts on goods or services provided by the employer in 1 line of business,
    for purposes of paragraphs (1) and (2) of section 132(a) (but not for purposes of section 132(h)), all employees of any line of business of the employer which was in existence on January 1, 1984, shall be treated as employees of the line of business referred to in paragraph (2).
  • 26 U.S.C. § 4977(c)(2)
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    (2) at all times on or after January 1, 1984, and before the close of the calendar year involved, substantially all of the employees of the employer were entitled to employee discounts on goods or services provided by the employer in 1 line of business,
  • 26 U.S.C. § 4977(e)
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    (e) All employees treated as employed by a single employer under subsection (b), (c), or (m) of section 414 shall be treated as employed by a single employer for purposes of this section.
  • 26 U.S.C. § 4978(a)
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    (a) If, during the 3-year period after the date on which the employee stock ownership plan or eligible worker-owned cooperative acquired any qualified securities in a sale to which section 1042 applied or acquired any qualified employer securities in a qualified gratuitous transfer to which section 664(g) applied, such plan or cooperative disposes of any qualified securities and—
    (1) the total number of shares held by such plan or cooperative after such disposition is less than the total number of employer securities held immediately after such sale, or
    (2) except to the extent provided in regulations, the value of qualified securities held by such plan or cooperative after such disposition is less than 30 percent of the total value of all employer securities as of such disposition (60 percent of the total value of all employer securities as of such disposition in the case of any qualified employer securities acquired in a qualified gratuitous transfer to which section 664(g) applied),
    there is hereby imposed a tax on the disposition equal to the amount determined under subsection (b).
  • 26 U.S.C. § 4978(b)(3)
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    (3) The amount realized on any distribution to an employee for less than fair market value shall be determined as if the qualified security had been sold to the employee at fair market value.
  • 26 U.S.C. § 4978(d)(1)(A)
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    (A) the death of the employee,
  • 26 U.S.C. § 4978(d)(1)(B)
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    (B) the retirement of the employee after the employee has attained 59½ years of age,
  • 26 U.S.C. § 4978(d)(1)(C)
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    (C) the disability of the employee (within the meaning of section 72(m)(7)), or
  • 26 U.S.C. § 4978(d)(1)(D)
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    (D) the separation of the employee from service for any period which results in a 1-year break in service (within the meaning of section 411(a)(6)(A)).
  • 26 U.S.C. § 4978(e)(1)
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    (1) The term “employee stock ownership plan” has the meaning given to such term by section 4975(e)(7).
  • 26 U.S.C. § 4979(e)(4)
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    (4) a simplified employee pension of an employer which satisfies the requirements of section 408(k), and
  • 26 U.S.C. § 4979A(a)(1)
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    (1) there is a prohibited allocation of qualified securities by any employee stock ownership plan or eligible worker-owned cooperative,
  • 26 U.S.C. § 4979A(a)(3)
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    (3) there is any allocation of employer securities which violates the provisions of section 409(p), or a nonallocation year described in subsection (e)(2)(C) with respect to an employee stock ownership plan, or
  • 26 U.S.C. § 4979A(e)(2)(C)
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    (C) For purposes of subparagraph (A), the amount involved for the first nonallocation year of any employee stock ownership plan shall be determined by taking into account the total value of all the deemed-owned shares of all disqualified persons with respect to such plan.
  • 26 U.S.C. § 4980(c)(2)(B)(i)
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    (i) except as provided in regulations, any amount distributed to or on behalf of any employee (or his beneficiaries) if such amount could have been so distributed before termination of such plan without violating any provision of section 401,
  • 26 U.S.C. § 4980(c)(3)(A)
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    (A) If, upon an employer reversion from a qualified plan, any applicable amount is transferred from such plan to an employee stock ownership plan described in section 4975(e)(7) or a tax credit employee stock ownership plan (as described in section 409), such amount shall not be treated as an employer reversion for purposes of this section (or includible in the gross income of the employer) if the requirements of subparagraphs (B), (C), and (D) are met.
  • 26 U.S.C. § 4980(c)(3)(C)(ii)(II)
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    (II) no additional employer contributions shall be permitted to an employee stock ownership plan described in subparagraph (A) of the employer before the allocation of such amount.
  • 26 U.S.C. § 4980(c)(3)(D)
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    (D) The requirements of this subparagraph are met if at least half of the participants in the qualified plan are participants in the employee stock ownership plan (as of the close of the 1st plan year for which an allocation of the securities is required).
  • 26 U.S.C. § 4980(c)(3)(F)
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    (F) No credit or deduction shall be allowed under chapter 1 for any amount transferred to an employee stock ownership plan in a transfer to which this paragraph applies.
  • 26 U.S.C. § 4980(d)(2)(A)
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    (A) At least 95 percent of the active participants in the terminated plan who remain as employees of the employer after the termination are active participants in the replacement plan.
  • 26 U.S.C. § 4980(d)(4)(C)
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    (C) Except as provided by the Secretary, section 415(b)(5)(D) shall not apply to any increase in benefits by reason of this subsection to the extent that the application of this subparagraph does not discriminate in favor of highly compensated employees (as defined in section 414(q)).
  • 26 U.S.C. § 4980B(d)(1)
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    (1) any failure of a group health plan to meet the requirements of subsection (f) with respect to any qualified beneficiary if the qualifying event with respect to such beneficiary occurred during the calendar year immediately following a calendar year during which all employers maintaining such plan normally employed fewer than 20 employees on a typical business day,
  • 26 U.S.C. § 4980B(e)(1)(B)
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    (B) Each person who is responsible (other than in a capacity as an employee) for administering or providing benefits under the plan and whose act or failure to act caused (in whole or in part) the failure.
  • 26 U.S.C. § 4980B(f)(2)(B)(i)(III)
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    (III) In the case of a qualifying event described in paragraph (3)(F) (relating to bankruptcy proceedings), the date of the death of the covered employee or qualified beneficiary (described in subsection (g)(1)(D)(iii)), or in the case of the surviving spouse or dependent children of the covered employee, 36 months after the date of the death of the covered employee.
  • 26 U.S.C. § 4980B(f)(2)(B)(i)(V)
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    (V) In the case of a qualifying event described in paragraph (3)(B) with respect to a covered employee who (as of such qualifying event) has a nonforfeitable right to a benefit any portion of which is to be paid by the Pension Benefit Guaranty Corporation under title IV of the Employee Retirement Income Security Act of 1974, notwithstanding subclause (I) or (II), the date of the death of the covered employee, or in the case of the surviving spouse or dependent children of the covered employee, 24 months after the date of the death of the covered employee. The preceding sentence shall not require any period of coverage to extend beyond January 1, 2014.
  • 26 U.S.C. § 4980B(f)(2)(B)(i)(VI)
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    (VI) In the case of a qualifying event described in paragraph (3)(B) with respect to a covered employee who is (as of the date that the period of coverage would, but for this subclause or subclause (VII), otherwise terminate under subclause (I) or (II)) a TAA-eligible individual (as defined in paragraph (5)(C)(iv)(II)), the period of coverage shall not terminate by reason of subclause (I) or (II), as the case may be, before the later of the date specified in such subclause or the date on which such individual ceases to be such a TAA-eligible individual. The preceding sentence shall not require any period of coverage to extend beyond January 1, 2014.
  • 26 U.S.C. § 4980B(f)(2)(B)(i)(VII)
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    (VII) In the case of a qualifying event described in paragraph (3)(B) that occurs less than 18 months after the date the covered employee became entitled to benefits under title XVIII of the Social Security Act, the period of coverage for qualified beneficiaries other than the covered employee shall not terminate under this clause before the close of the 36-month period beginning on the date the covered employee became so entitled.
  • 26 U.S.C. § 4980B(f)(2)(B)(ii)
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    (ii) The date on which the employer ceases to provide any group health plan to any employee.
  • 26 U.S.C. § 4980B(f)(2)(B)(iv)(I)
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    (I) covered under any other group health plan (as an employee or otherwise) which does not contain any exclusion or limitation with respect to any preexisting condition of such beneficiary (other than such an exclusion or limitation which does not apply to (or is satisfied by) such beneficiary by reason of chapter 100 of this title, part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974, or title XXVII of the Public Health Service Act), or
  • 26 U.S.C. § 4980B(f)(3)
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    (3) For purposes of this subsection, the term “qualifying event” means, with respect to any covered employee, any of the following events which, but for the continuation coverage required under this subsection, would result in the loss of coverage of a qualified beneficiary—
    (A) The death of the covered employee.
    (B) The termination (other than by reason of such employee’s gross misconduct), or reduction of hours, of the covered employee’s employment.
    (C) The divorce or legal separation of the covered employee from the employee’s spouse.
    (D) The covered employee becoming entitled to benefits under title XVIII of the Social Security Act.
    (E) A dependent child ceasing to be a dependent child under the generally applicable requirements of the plan.
    (F) A proceeding in a case under title 11, United States Code, commencing on or after July 1, 1986, with respect to the employer from whose employment the covered employee retired at any time.
    In the case of an event described in subparagraph (F), a loss of coverage includes a substantial elimination of coverage with respect to a qualified beneficiary described in subsection (g)(1)(D) within one year before or after the date of commencement of the proceeding.
  • 26 U.S.C. § 4980B(f)(3)(A)
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    (A) The death of the covered employee.
  • 26 U.S.C. § 4980B(f)(3)(B)
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    (B) The termination (other than by reason of such employee’s gross misconduct), or reduction of hours, of the covered employee’s employment.
  • 26 U.S.C. § 4980B(f)(3)(C)
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    (C) The divorce or legal separation of the covered employee from the employee’s spouse.
  • 26 U.S.C. § 4980B(f)(3)(D)
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    (D) The covered employee becoming entitled to benefits under title XVIII of the Social Security Act.
  • 26 U.S.C. § 4980B(f)(3)(F)
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    (F) A proceeding in a case under title 11, United States Code, commencing on or after July 1, 1986, with respect to the employer from whose employment the covered employee retired at any time.
  • 26 U.S.C. § 4980B(f)(4)(A)
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    (A) The term “applicable premium” means, with respect to any period of continuation coverage of qualified beneficiaries, the cost to the plan for such period of the coverage for similarly situated beneficiaries with respect to whom a qualifying event has not occurred (without regard to whether such cost is paid by the employer or employee).
  • 26 U.S.C. § 4980B(f)(4)(B)(iii)
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    (iii) A plan administrator may not elect to have clause (ii) apply in any case in which there is any significant difference between the determination period and the preceding determination period, in coverage under, or in employees covered by, the plan. The determination under the preceding sentence for any determination period shall be made at the same time as the determination under subparagraph (C).
  • 26 U.S.C. § 4980B(f)(5)(C)
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    (i) In the case of a nonelecting TAA-eligible individual and notwithstanding subparagraph (A), such individual may elect continuation coverage under this subsection during the 60-day period that begins on the first day of the month in which the individual becomes a TAA-eligible individual, but only if such election is made not later than 6 months after the date of the TAA-related loss of coverage.
    (ii) Any continuation coverage elected by a TAA-eligible individual under clause (i) shall commence at the beginning of the 60-day election period described in such paragraph and shall not include any period prior to such 60-day election period.
    (iii) With respect to an individual who elects continuation coverage pursuant to clause (i), the period—
    (I) beginning on the date of the TAA-related loss of coverage, and
    (II) ending on the first day of the 60-day election period described in clause (i),
    shall be disregarded for purposes of determining the 63-day periods referred to in section 9801(c)(2), section 701(c)(2) of the Employee Retirement Income Security Act of 1974, and section 2704(c)(2) of the Public Health Service Act.
    (iv) For purposes of this subsection:
    (I) The term “nonelecting TAA-eligible individual” means a TAA-eligible individual who has a TAA-related loss of coverage and did not elect continuation coverage under this subsection during the TAA-related election period.
    (II) The term “TAA-eligible individual” means an eligible TAA recipient (as defined in paragraph (2) of section 35(c)) and an eligible alternative TAA recipient (as defined in paragraph (3) of such section).
    (III) The term “TAA-related election period” means, with respect to a TAA-related loss of coverage, the 60-day election period under this subsection which is a direct consequence of such loss.
    (IV) The term “TAA-related loss of coverage” means, with respect to an individual whose separation from employment gives rise to being an TAA-eligible individual, the loss of health benefits coverage associated with such separation.
  • 26 U.S.C. § 4980B(f)(6)
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    (6) In accordance with regulations prescribed by the Secretary—
    (A) The group health plan shall provide, at the time of commencement of coverage under the plan, written notice to each covered employee and spouse of the employee (if any) of the rights provided under this subsection.
    (B) The employer of an employee under a plan must notify the plan administrator of a qualifying event described in subparagraph (A), (B), (D), or (F) of paragraph (3) with respect to such employee within 30 days (or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan) of the date of the qualifying event.
    (C) Each covered employee or qualified beneficiary is responsible for notifying the plan administrator of the occurrence of any qualifying event described in subparagraph (C) or (E) of paragraph (3) within 60 days after the date of the qualifying event and each qualified beneficiary who is determined, under title II or XVI of the Social Security Act, to have been disabled at any time during the first 60 days of continuation coverage under this section is responsible for notifying the plan administrator of such determination within 60 days after the date of the determination and for notifying the plan administrator within 30 days of the date of any final determination under such title or titles that the qualified beneficiary is no longer disabled.
    (D) The plan administrator shall notify—
    (i) in the case of a qualifying event described in subparagraph (A), (B), (D), or (F) of paragraph (3), any qualified beneficiary with respect to such event, and
    (ii) in the case of a qualifying event described in subparagraph (C) or (E) of paragraph (3) where the covered employee notifies the plan administrator under subparagraph (C), any qualified beneficiary with respect to such event,
    of such beneficiary’s rights under this subsection.
    The requirements of subparagraph (B) shall be considered satisfied in the case of a multiemployer plan in connection with a qualifying event described in paragraph (3)(B) if the plan provides that the determination of the occurrence of such qualifying event will be made by the plan administrator. For purposes of subparagraph (D), any notification shall be made within 14 days (or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan) of the date on which the plan administrator is notified under subparagraph (B) or (C), whichever is applicable, and any such notification to an individual who is a qualified beneficiary as the spouse of the covered employee shall be treated as notification to all other qualified beneficiaries residing with such spouse at the time such notification is made.
  • 26 U.S.C. § 4980B(f)(6)(A)
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    (A) The group health plan shall provide, at the time of commencement of coverage under the plan, written notice to each covered employee and spouse of the employee (if any) of the rights provided under this subsection.
  • 26 U.S.C. § 4980B(f)(6)(B)
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    (B) The employer of an employee under a plan must notify the plan administrator of a qualifying event described in subparagraph (A), (B), (D), or (F) of paragraph (3) with respect to such employee within 30 days (or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan) of the date of the qualifying event.
  • 26 U.S.C. § 4980B(f)(6)(C)
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    (C) Each covered employee or qualified beneficiary is responsible for notifying the plan administrator of the occurrence of any qualifying event described in subparagraph (C) or (E) of paragraph (3) within 60 days after the date of the qualifying event and each qualified beneficiary who is determined, under title II or XVI of the Social Security Act, to have been disabled at any time during the first 60 days of continuation coverage under this section is responsible for notifying the plan administrator of such determination within 60 days after the date of the determination and for notifying the plan administrator within 30 days of the date of any final determination under such title or titles that the qualified beneficiary is no longer disabled.
  • 26 U.S.C. § 4980B(f)(6)(D)(ii)
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    (ii) in the case of a qualifying event described in subparagraph (C) or (E) of paragraph (3) where the covered employee notifies the plan administrator under subparagraph (C), any qualified beneficiary with respect to such event,
  • 26 U.S.C. § 4980B(f)(7)
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    (7) For purposes of this subsection, the term “covered employee” means an individual who is (or was) provided coverage under a group health plan by virtue of the performance of services by the individual for 1 or more persons maintaining the plan (including as an employee defined in section 401(c)(1)).
  • 26 U.S.C. § 4980B(g)(1)(A)
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    (A) The term “qualified beneficiary” means, with respect to a covered employee under a group health plan, any other individual who, on the day before the qualifying event for that employee, is a beneficiary under the plan—
    (i) as the spouse of the covered employee, or
    (ii) as the dependent child of the employee.
    Such term shall also include a child who is born to or placed for adoption with the covered employee during the period of continuation coverage under this section.
  • 26 U.S.C. § 4980B(g)(1)(A)(i)
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    (i) as the spouse of the covered employee, or
  • 26 U.S.C. § 4980B(g)(1)(A)(ii)
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    (ii) as the dependent child of the employee.
  • 26 U.S.C. § 4980B(g)(1)(B)
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    (B) In the case of a qualifying event described in subsection (f)(3)(B), the term “qualified beneficiary” includes the covered employee.
  • 26 U.S.C. § 4980B(g)(1)(C)
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    (C) Notwithstanding subparagraphs (A) and (B), the term “qualified beneficiary” does not include an individual whose status as a covered employee is attributable to a period in which such individual was a nonresident alien who received no earned income (within the meaning of section 911(d)(2)) from the employer which constituted income from sources within the United States (within the meaning of section 861(a)(3)). If an individual is not a qualified beneficiary pursuant to the previous sentence, a spouse or dependent child of such individual shall not be considered a qualified beneficiary by virtue of the relationship of the individual.
  • 26 U.S.C. § 4980B(g)(1)(D)
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    (D) In the case of a qualifying event described in subsection (f)(3)(F), the term “qualified beneficiary” includes a covered employee who had retired on or before the date of substantial elimination of coverage and any other individual who, on the day before such qualifying event, is a beneficiary under the plan—
    (i) as the spouse of the covered employee,
    (ii) as the dependent child of the covered employee, or
    (iii) as the surviving spouse of the covered employee.
  • 26 U.S.C. § 4980B(g)(1)(D)(i)
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    (i) as the spouse of the covered employee,
  • 26 U.S.C. § 4980B(g)(1)(D)(ii)
    Go to provision →
    (ii) as the dependent child of the covered employee, or
  • 26 U.S.C. § 4980B(g)(1)(D)(iii)
    Go to provision →
    (iii) as the surviving spouse of the covered employee.
  • 26 U.S.C. § 4980B(g)(3)
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    (3) The term “plan administrator” has the meaning given the term “administrator” by section 3(16)(A) of the Employee Retirement Income Security Act of 1974.
  • 26 U.S.C. § 4980D(d)(2)(A)
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    (A) For purposes of paragraph (1), the term “small employer” means, with respect to a calendar year and a plan year, an employer who employed an average of at least 2 but not more than 50 employees on business days during the preceding calendar year and who employs at least 2 employees on the first day of the plan year. For purposes of the preceding sentence, all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 shall be treated as one employer.
  • 26 U.S.C. § 4980D(d)(2)(B)
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    (B) In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether such employer is a small employer shall be based on the average number of employees that it is reasonably expected such employer will employ on business days in the current calendar year.
  • 26 U.S.C. § 4980D(f)(2)(B)
    Go to provision →
    (B) any multiple employer welfare arrangement (as defined in section 3(40) of the Employee Retirement Income Security Act of 1974, as in effect on the date of the enactment of this section).
  • 26 U.S.C. § 4980E(a)
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    (a) In the case of an employer who makes a contribution to the Archer MSA of any employee with respect to coverage under a high deductible health plan of the employer during a calendar year, there is hereby imposed a tax on the failure of such employer to meet the requirements of subsection (d) for such calendar year.
  • 26 U.S.C. § 4980E(b)
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    (b) The amount of the tax imposed by subsection (a) on any failure for any calendar year is the amount equal to 35 percent of the aggregate amount contributed by the employer to Archer MSAs of employees for taxable years of such employees ending with or within such calendar year.
  • 26 U.S.C. § 4980E(d)(1)
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    (1) An employer meets the requirements of this subsection for any calendar year if the employer makes available comparable contributions to the Archer MSAs of all comparable participating employees for each coverage period during such calendar year.
  • 26 U.S.C. § 4980E(d)(2)(A)(ii)
    Go to provision →
    (ii) which are the same percentage of the annual deductible limit under the high deductible health plan covering the employees.
  • 26 U.S.C. § 4980E(d)(2)(B)
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    (B) In the case of an employee who is employed by the employer for only a portion of the calendar year, a contribution to the Archer MSA of such employee shall be treated as comparable if it is an amount which bears the same ratio to the comparable amount (determined without regard to this subparagraph) as such portion bears to the entire calendar year.
  • 26 U.S.C. § 4980E(d)(3)
    Go to provision →
    (3) For purposes of paragraph (1), the term “comparable participating employees” means all employees—
    (A) who are eligible individuals covered under any high deductible health plan of the employer, and
    (B) who have the same category of coverage.
    For purposes of subparagraph (B), the categories of coverage are self-only and family coverage.
  • 26 U.S.C. § 4980E(d)(4)(A)
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    (A) Paragraph (3) shall be applied separately with respect to part-time employees and other employees.
  • 26 U.S.C. § 4980E(d)(4)(B)
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    (B) For purposes of subparagraph (A), the term “part-time employee” means any employee who is customarily employed for fewer than 30 hours per week.
  • 26 U.S.C. § 4980F(e)(1)
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    (1) If an applicable pension plan is amended to provide for a significant reduction in the rate of future benefit accrual, the plan administrator shall provide the notice described in paragraph (2) to each applicable individual (and to each employee organization representing applicable individuals) and to each employer who has an obligation to contribute to the plan.
  • 26 U.S.C. § 4980G(a)
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    (a) In the case of an employer who makes a contribution to the health savings account of any employee during a calendar year, there is hereby imposed a tax on the failure of such employer to meet the requirements of subsection (b) for such calendar year.
  • 26 U.S.C. § 4980G(d)
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    (d) For purposes of applying section 4980E to a contribution to a health savings account of an employee who is not a highly compensated employee (as defined in section 414(q)), highly compensated employees shall not be treated as comparable participating employees.
  • 26 U.S.C. § 4980H(a)
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    (a) If—
    (1) any applicable large employer fails to offer to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan (as defined in section 5000A(f)(2)) for any month, and
    (2) at least one full-time employee of the applicable large employer has been certified to the employer under section 1411 of the Patient Protection and Affordable Care Act as having enrolled for such month in a qualified health plan with respect to which an applicable premium tax credit or cost-sharing reduction is allowed or paid with respect to the employee,
    then there is hereby imposed on the employer an assessable payment equal to the product of the applicable payment amount and the number of individuals employed by the employer as full-time employees during such month.
  • 26 U.S.C. § 4980H(a)(1)
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    (1) any applicable large employer fails to offer to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan (as defined in section 5000A(f)(2)) for any month, and
  • 26 U.S.C. § 4980H(a)(2)
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    (2) at least one full-time employee of the applicable large employer has been certified to the employer under section 1411 of the Patient Protection and Affordable Care Act as having enrolled for such month in a qualified health plan with respect to which an applicable premium tax credit or cost-sharing reduction is allowed or paid with respect to the employee,
  • 26 U.S.C. § 4980H(b)(1)
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    (1) If—
    (A) an applicable large employer offers to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan (as defined in section 5000A(f)(2)) for any month, and
    (B) 1 or more full-time employees of the applicable large employer has been certified to the employer under section 1411 of the Patient Protection and Affordable Care Act as having enrolled for such month in a qualified health plan with respect to which an applicable premium tax credit or cost-sharing reduction is allowed or paid with respect to the employee,
    then there is hereby imposed on the employer an assessable payment equal to the product of the number of full-time employees of the applicable large employer described in subparagraph (B) for such month and an amount equal to 1⁄12 of $3,000.
  • 26 U.S.C. § 4980H(b)(1)(A)
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    (A) an applicable large employer offers to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan (as defined in section 5000A(f)(2)) for any month, and
  • 26 U.S.C. § 4980H(b)(1)(B)
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    (B) 1 or more full-time employees of the applicable large employer has been certified to the employer under section 1411 of the Patient Protection and Affordable Care Act as having enrolled for such month in a qualified health plan with respect to which an applicable premium tax credit or cost-sharing reduction is allowed or paid with respect to the employee,
  • 26 U.S.C. § 4980H(b)(2)
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    (2) The aggregate amount of tax determined under paragraph (1) with respect to all employees of an applicable large employer for any month shall not exceed the product of the applicable payment amount and the number of individuals employed by the employer as full-time employees during such month.
  • 26 U.S.C. § 4980H(c)(2)(A)
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    (A) The term “applicable large employer” means, with respect to a calendar year, an employer who employed an average of at least 50 full-time employees on business days during the preceding calendar year.
  • 26 U.S.C. § 4980H(c)(2)(B)(i)
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    (i) An employer shall not be considered to employ more than 50 full-time employees if—
    (I) the employer’s workforce exceeds 50 full-time employees for 120 days or fewer during the calendar year, and
    (II) the employees in excess of 50 employed during such 120-day period were seasonal workers.
  • 26 U.S.C. § 4980H(c)(2)(B)(i)(I)
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    (I) the employer’s workforce exceeds 50 full-time employees for 120 days or fewer during the calendar year, and
  • 26 U.S.C. § 4980H(c)(2)(B)(i)(II)
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    (II) the employees in excess of 50 employed during such 120-day period were seasonal workers.
  • 26 U.S.C. § 4980H(c)(2)(C)(ii)
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    (ii) In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether such employer is an applicable large employer shall be based on the average number of employees that it is reasonably expected such employer will employ on business days in the current calendar year.
  • 26 U.S.C. § 4980H(c)(2)(D)(i)
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    (i) The number of individuals employed by an applicable large employer as full-time employees during any month shall be reduced by 30 solely for purposes of calculating—
    (I) the assessable payment under subsection (a), or
    (II) the overall limitation under subsection (b)(2).
  • 26 U.S.C. § 4980H(c)(2)(D)(ii)
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    (ii) In the case of persons treated as 1 employer under subparagraph (C)(i), only 1 reduction under subclause (I) or (II)1 shall be allowed with respect to such persons and such reduction shall be allocated among such persons ratably on the basis of the number of full-time employees employed by each such person.
  • 26 U.S.C. § 4980H(c)(2)(E)
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    (E) Solely for purposes of determining whether an employer is an applicable large employer under this paragraph, an employer shall, in addition to the number of full-time employees for any month otherwise determined, include for such month a number of full-time employees determined by dividing the aggregate number of hours of service of employees who are not full-time employees for the month by 120.
  • 26 U.S.C. § 4980H(c)(2)(F)
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    (F) Solely for purposes of determining whether an employer is an applicable large employer under this paragraph for any month, an individual shall not be taken into account as an employee for such month if such individual has medical coverage for such month under—
    (i) chapter 55 of title 10, United States Code, including coverage under the TRICARE program, or
    (ii) under a health care program under chapter 17 or 18 of title 38, United States Code, as determined by the Secretary of Veterans Affairs, in coordination with the Secretary of Health and Human Services and the Secretary.
  • 26 U.S.C. § 4980H(c)(4)(A)
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    (A) The term “full-time employee” means, with respect to any month, an employee who is employed on average at least 30 hours of service per week.
  • 26 U.S.C. § 4980H(c)(4)(B)
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    (B) The Secretary, in consultation with the Secretary of Labor, shall prescribe such regulations, rules, and guidance as may be necessary to determine the hours of service of an employee, including rules for the application of this paragraph to employees who are not compensated on an hourly basis.
  • 26 U.S.C. § 4980H(d)(3)
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    (3) The Secretary shall prescribe rules, regulations, or guidance for the repayment of any assessable payment (including interest) if such payment is based on the allowance or payment of an applicable premium tax credit or cost-sharing reduction with respect to an employee, such allowance or payment is subsequently disallowed, and the assessable payment would not have been required to be made but for such allowance or payment.
  • 26 U.S.C. § 5000(a)
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    (a) There is hereby imposed on any employer (including a self-employed person) or employee organization that contributes to a nonconforming group health plan a tax equal to 25 percent of the employer’s or employee organization’s expenses incurred during the calendar year for each group health plan to which the employer or employee organization contributes.
  • 26 U.S.C. § 5000(b)(1)
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    (1) The term “group health plan” means a plan (including a self-insured plan) of, or contributed to by, an employer (including a self-employed person) or employee organization to provide health care (directly or otherwise) to the employees, former employees, the employer, others associated or formerly associated with the employer in a business relationship, or their families.
  • 26 U.S.C. § 5000(b)(2)
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    (2) The term “large group health plan” means a plan of, or contributed to by, an employer or employee organization (including a self-insured plan) to provide health care (directly or otherwise) to the employees, former employees, the employer, others associated or formerly associated with the employer in a business relationship, or their families, that covers employees of at least one employer that normally employed at least 100 employees on a typical business day during the previous calendar year. For purposes of the preceding sentence—
    (A) all employers treated as a single employer under subsection (a) or (b) of section 52 shall be treated as a single employer,
    (B) all employees of the members of an affiliated service group (as defined in section 414(m)) shall be treated as employed by a single employer, and
    (C) leased employees (as defined in section 414(n)(2)) shall be treated as employees of the person for whom they perform services to the extent they are so treated under section 414(n).
  • 26 U.S.C. § 5000(b)(2)(B)
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    (B) all employees of the members of an affiliated service group (as defined in section 414(m)) shall be treated as employed by a single employer, and
  • 26 U.S.C. § 5000(b)(2)(C)
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    (C) leased employees (as defined in section 414(n)(2)) shall be treated as employees of the person for whom they perform services to the extent they are so treated under section 414(n).
  • 26 U.S.C. § 5000A(e)(1)(C)
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    (C) For purposes of subparagraph (B)(i), if an applicable individual is eligible for minimum essential coverage through an employer by reason of a relationship to an employee, the determination under subparagraph (A) shall be made by reference to1 required contribution of the employee.
  • 26 U.S.C. § 5000A(f)(2)
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    (2) The term “eligible employer-sponsored plan” means, with respect to any employee, a group health plan or group health insurance coverage offered by an employer to the employee which is—
    (A) a governmental plan (within the meaning of section 2791(d)(8) of the Public Health Service Act), or
    (B) any other plan or coverage offered in the small or large group market within a State.
    Such term shall include a grandfathered health plan described in paragraph (1)(D) offered in a group market.
  • 26 U.S.C. § 5008(a)(1)(A)
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    (A) In the case of loss by theft, unless the Secretary finds that the theft occurred without connivance, collusion, fraud, or negligence on the part of the proprietor of the distilled spirits plant, owner, consignor, consignee, bailee, or carrier, or the employees or agents of any of them;
  • 26 U.S.C. § 5008(a)(2)
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    (2) In any case in which distilled spirits are lost or destroyed, whether by theft or otherwise, the Secretary may require the proprietor of the distilled spirits plant or other person liable for the tax to file a claim for relief from the tax and submit proof as to the cause of such loss. In every case where it appears that the loss was by theft, the burden shall be upon the proprietor of the distilled spirits plant or other person responsible for the distilled spirits tax to establish to the satisfaction of the Secretary that such loss did not occur as the result of connivance, collusion, fraud, or negligence on the part of the proprietor of the distilled spirits plant, owner, consignor, consignee, bailee, or carrier, or the employees or agents of any of them.
  • 26 U.S.C. § 5056(b)
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    (b) Subject to regulations prescribed by the Secretary, the tax paid by any brewer on beer removed for consumption or sale may be refunded or credited to the brewer, without interest, or if the tax has not been paid, the brewer may be relieved of liability therefor, if such beer is lost, whether by theft or otherwise, or is destroyed or otherwise rendered unmerchantable by fire, casualty, or act of God before the transfer of title thereto to any other person. In any case in which beer is lost or destroyed, whether by theft or otherwise, the Secretary may require the brewer to file a claim for relief from the tax and submit proof as to the cause of such loss. In every case where it appears that the loss was by theft, the first sentence shall not apply unless the brewer establishes to the satisfaction of the Secretary that such theft occurred before removal from the brewery and occurred without connivance, collusion, fraud, or negligence on the part of the brewer, consignor, consignee, bailee, or carrier, or the employees or agents of any of them.
  • 26 U.S.C. § 5113
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    For the purpose of ascertaining the correctness of any claim filed under this subpart, the Secretary is authorized to examine any books, papers, records, or memoranda bearing upon the matters required to be alleged in the claim, to require the attendance of the person filing the claim or of any officer or employee of such person or the attendance of any other person having knowledge in the premises, to take testimony with reference to any matter covered by the claim, and to administer oaths to any person giving such testimony.
  • 26 U.S.C. § 5171(d)(2)
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    (2) Paragraph (1) shall not apply to any agency of a State or political subdivision thereof or to any officer or employee of any such agency, and no such agency, officer, or employee shall be required to obtain a permit thereunder.
  • 26 U.S.C. § 5301(c)
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    (c) No person who sells, or offers for sale, distilled spirits, or agent or employee of such person, shall—
    (1) place in any liquor bottle any distilled spirits whatsoever other than those contained in such bottle at the time of tax determination under the provisions of this chapter; or
    (2) possess any liquor bottle in which any distilled spirits have been placed in violation of the provisions of paragraph (1); or
    (3) by the addition of any substance whatsoever to any liquor bottle, in any manner alter or increase any portion of the original contents contained in such bottle at the time of tax determination under the provisions of this chapter; or
    (4) possess any liquor bottle, any portion of the contents of which has been altered or increased in violation of the provisions of paragraph (3);
    except that the Secretary may by regulations authorize the reuse of liquor bottles, under such conditions as he may by regulations prescribe. When used in this subsection the term “liquor bottle” shall mean a liquor bottle or other container which has been used for the bottling or packaging of distilled spirits under regulations issued pursuant to subsection (a).
  • 26 U.S.C. § 5370(a)(1)
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    (1) In the case of loss by theft, unless the Secretary shall find that the theft occurred without connivance, collusion, fraud, or negligence on the part of the proprietor or other person responsible for the tax, or the owner, consignor, consignee, bailee, or carrier, or the agents or employees of any of them; and
  • 26 U.S.C. § 5370(b)
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    (b) In any case in which the wine is lost or destroyed, whether by theft or otherwise, the Secretary may require by regulations the proprietor of the bonded wine cellar or other person liable for the tax to file a claim for relief from the tax and submit proof as to the cause of such loss. In every case where it appears that the loss was by theft, the burden shall be on the proprietor or other person liable for the tax to establish to the satisfaction of the Secretary, that such loss did not occur as the result of connivance, collusion, fraud, or negligence on the part of the proprietor, owner, consignor, consignee, bailee, or carrier, or the agents or employees of any of them.
  • 26 U.S.C. § 5661(b)
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    (b) Any proprietor of premises subject to the provisions of subchapter F, or any employee or agent of such proprietor, or any other person, who otherwise than with intent to defraud the United States violates or fails to comply with any provision of subchapter F or subpart C of part I of subchapter A, or regulations issued pursuant thereto, or who aids or abets in any such violation, shall be fined not more than $1,000, or imprisoned not more than 1 year, or both, for each such offense.
  • 26 U.S.C. § 5690
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    The term “person”, as used in this subchapter, includes an officer or employee of a corporation or a member or employee of a partnership, who as such officer, employee, or member is under a duty to perform the act in respect of which the violation occurs.
  • 26 U.S.C. § 5704(a)
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    (a) Tobacco products may be furnished by a manufacturer of such products, without payment of tax, for use or consumption by employees or for experimental purposes, in such quantities, and in such manner as the Secretary shall by regulation prescribed.
  • 26 U.S.C. § 5723(e)
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    (e) Tobacco products furnished by manufacturers of such products for use or consumption by their employees, or for experimental purposes, and tobacco products, processed tobacco, and cigarette papers and tubes transferred to the bonded premises of another manufacturer or export warehouse proprietor or released in bond from customs custody for deliver to a manufacturer of tobacco products, processed tobacco, or cigarette papers and tubes, may be exempted from subsection (a) and (b) in accordance with such regulations as the Secretary shall prescribe.
  • 26 U.S.C. § 9702(a)(3)(B)
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    (B) an employee welfare benefit plan within the meaning of section 3(1) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(1)), and
  • 26 U.S.C. § 9711(e)
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    (e) The existence, level, and duration of benefits provided to former employees of a last signatory operator (and their eligible beneficiaries) who are not otherwise covered by this chapter and who are (or were) covered by a coal wage agreement shall only be determined by, and shall be subject to, collective bargaining, lawful unilateral action, or other applicable law.
  • 26 U.S.C. § 9712(a)(2)(B)
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    (B) an employee welfare benefit plan within the meaning of section 3(1) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(1)), and
  • 26 U.S.C. § 9721
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    The provisions of section 4301 of the Employee Retirement Income Security Act of 1974 shall apply, in the same manner as any claim arising out of an obligation to pay withdrawal liability under subtitle E of title IV of such Act, to any claim—
  • 26 U.S.C. § 9801(f)(1)
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    (1) A group health plan shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if each of the following conditions is met:
    (A) The employee or dependent was covered under a group health plan or had health insurance coverage at the time coverage was previously offered to the employee or individual.
    (B) The employee stated in writing at such time that coverage under a group health plan or health insurance coverage was the reason for declining enrollment, but only if the plan sponsor (or the health insurance issuer offering health insurance coverage in connection with the plan) required such a statement at such time and provided the employee with notice of such requirement (and the consequences of such requirement) at such time.
    (C) The employee’s or dependent’s coverage described in subparagraph (A)—
    (i) was under a COBRA continuation provision and the coverage under such provision was exhausted; or
    (ii) was not under such a provision and either the coverage was terminated as a result of loss of eligibility for the coverage (including as a result of legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment) or employer contributions toward such coverage were terminated.
    (D) Under the terms of the plan, the employee requests such enrollment not later than 30 days after the date of exhaustion of coverage described in subparagraph (C)(i) or termination of coverage or employer contribution described in subparagraph (C)(ii).
  • 26 U.S.C. § 9801(f)(1)(A)
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    (A) The employee or dependent was covered under a group health plan or had health insurance coverage at the time coverage was previously offered to the employee or individual.
  • 26 U.S.C. § 9801(f)(1)(B)
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    (B) The employee stated in writing at such time that coverage under a group health plan or health insurance coverage was the reason for declining enrollment, but only if the plan sponsor (or the health insurance issuer offering health insurance coverage in connection with the plan) required such a statement at such time and provided the employee with notice of such requirement (and the consequences of such requirement) at such time.
  • 26 U.S.C. § 9801(f)(1)(C)
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    (C) The employee’s or dependent’s coverage described in subparagraph (A)—
    (i) was under a COBRA continuation provision and the coverage under such provision was exhausted; or
    (ii) was not under such a provision and either the coverage was terminated as a result of loss of eligibility for the coverage (including as a result of legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment) or employer contributions toward such coverage were terminated.
  • 26 U.S.C. § 9801(f)(1)(D)
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    (D) Under the terms of the plan, the employee requests such enrollment not later than 30 days after the date of exhaustion of coverage described in subparagraph (C)(i) or termination of coverage or employer contribution described in subparagraph (C)(ii).
  • 26 U.S.C. § 9801(f)(3)(A)
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    (A) A group health plan shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if either of the following conditions is met:
    (i) The employee or dependent is covered under a Medicaid plan under title XIX of the Social Security Act or under a State child health plan under title XXI of such Act and coverage of the employee or dependent under such a plan is terminated as a result of loss of eligibility for such coverage and the employee requests coverage under the group health plan not later than 60 days after the date of termination of such coverage.
    (ii) The employee or dependent becomes eligible for assistance, with respect to coverage under the group health plan under such Medicaid plan or State child health plan (including under any waiver or demonstration project conducted under or in relation to such a plan), if the employee requests coverage under the group health plan not later than 60 days after the date the employee or dependent is determined to be eligible for such assistance.
  • 26 U.S.C. § 9801(f)(3)(A)(i)
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    (i) The employee or dependent is covered under a Medicaid plan under title XIX of the Social Security Act or under a State child health plan under title XXI of such Act and coverage of the employee or dependent under such a plan is terminated as a result of loss of eligibility for such coverage and the employee requests coverage under the group health plan not later than 60 days after the date of termination of such coverage.
  • 26 U.S.C. § 9801(f)(3)(A)(ii)
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    (ii) The employee or dependent becomes eligible for assistance, with respect to coverage under the group health plan under such Medicaid plan or State child health plan (including under any waiver or demonstration project conducted under or in relation to such a plan), if the employee requests coverage under the group health plan not later than 60 days after the date the employee or dependent is determined to be eligible for such assistance.
  • 26 U.S.C. § 9801(f)(3)(B)(i)(I)
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    (I) Each employer that maintains a group health plan in a State that provides medical assistance under a State Medicaid plan under title XIX of the Social Security Act, or child health assistance under a State child health plan under title XXI of such Act, in the form of premium assistance for the purchase of coverage under a group health plan, shall provide to each employee a written notice informing the employee of potential opportunities then currently available in the State in which the employee resides for premium assistance under such plans for health coverage of the employee or the employee’s dependents. For purposes of compliance with this clause, the employer may use any State-specific model notice developed in accordance with section 701(f)(3)(B)(i)(II) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181(f)(3)(B)(i)(II)).
  • 26 U.S.C. § 9801(f)(3)(B)(i)(II)
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    (II) An employer may provide the model notice applicable to the State in which an employee resides concurrent with the furnishing of materials notifying the employee of health plan eligibility, concurrent with materials provided to the employee in connection with an open season or election process conducted under the plan, or concurrent with the furnishing of the summary plan description as provided in section 104(b) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1024).
  • 26 U.S.C. § 9802(f)(1)
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    (1) both any employee of an employer with 10 or less employees (determined without regard to section 414(e)(3)(C)) and any self-employed individual, or
  • 26 U.S.C. § 9803(a)(6)
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    (6) for failure to meet the terms of an applicable collective bargaining agreement, to renew a collective bargaining or other agreement requiring or authorizing contributions to the plan, or to employ employees covered by such an agreement.
  • 26 U.S.C. § 9803(b)
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    (b) For purposes of subsection (a), the term “multiple employer welfare arrangement” has the meaning given such term by section 3(40) of the Employee Retirement Income Security Act of 1974, as in effect on the date of the enactment of this section.
  • 26 U.S.C. § 9812(a)(6)(A)
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    (A) The Secretary, the Secretary of Health and Human Services, and the Secretary of Labor, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall issue a compliance program guidance document to help improve compliance with this section, section 2726 of the Public Health Service Act, and section 712 of the Employee Retirement Income Security Act of 1974, as applicable. In carrying out this paragraph, the Secretaries may take into consideration the 2016 publication of the Department of Health and Human Services and the Department of Labor, entitled “Warning Signs - Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance”.
  • 26 U.S.C. § 9812(a)(6)(B)(i)
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    (i) The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, based on investigations of violations of such sections, including—
    (I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and
    (II) descriptions of the violations uncovered during the course of such investigations.
  • 26 U.S.C. § 9812(a)(6)(B)(iii)(I)
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    (I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable; and
  • 26 U.S.C. § 9812(a)(6)(B)(iii)(II)
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    (II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.
  • 26 U.S.C. § 9812(a)(6)(C)
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    (C) The compliance program guidance document shall include recommendations to advance compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits.
  • 26 U.S.C. § 9812(a)(6)(D)
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    (D) The Secretary, the Secretary of Health and Human Services, and the Secretary of Labor, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall update the compliance program guidance document every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.
  • 26 U.S.C. § 9812(a)(7)(A)
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    (A) The Secretary, the Secretary of Health and Human Services, and the Secretary of Labor shall issue guidance to group health plans to assist such plans in satisfying the requirements of this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.
  • 26 U.S.C. § 9812(a)(7)(B)(i)
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    (i) The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans may use for disclosing information to ensure compliance with the requirements under this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, (and any regulations promulgated pursuant to such sections, as applicable).
  • 26 U.S.C. § 9812(a)(7)(B)(ii)
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    (ii) The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, compliance with any regulation issued pursuant to such respective section, or compliance with any other applicable law or regulation. Such guidance shall include information that is comparative in nature with respect to—
    (I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits;
    (II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and
    (III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits.
  • 26 U.S.C. § 9812(a)(7)(C)
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    (C) The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, (and any regulations promulgated pursuant to such respective section), including—
    (i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to—
    (I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative;
    (II) limitations with respect to prescription drug formulary design; and
    (III) use of fail-first or step therapy protocols;
    (ii) examples of methods of determining—
    (I) network admission standards (such as credentialing); and
    (II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy;
    (iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations;
    (iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans in performing a nonquantitative treatment limitation analysis;
    (v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative;
    (vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits;
    (vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques;
    (viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and
    (ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.
  • 26 U.S.C. § 9812(a)(7)(C)(ix)
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    (ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.
  • 26 U.S.C. § 9812(c)(1)(B)
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    (B) For purposes of subparagraph (A), the term “small employer” means, with respect to a calendar year and a plan year, an employer who employed an average of at least 2 (or 1 in the case of an employer residing in a State that permits small groups to include a single individual) but not more than 50 employees on business days during the preceding calendar year. For purposes of the preceding sentence, all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 shall be treated as 1 employer and rules similar to rules of subparagraphs (B) and (C) of section 4980D(d)(2) shall apply.
  • 26 U.S.C. § 9816(a)(1)(D)
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    (D) without regard to any other term or condition of such coverage (other than exclusion or coordination of benefits, or an affiliation or waiting period, permitted under section 2704 of the Public Health Service Act, including as incorporated pursuant to section 715 of the Employee Retirement Income Security Act of 1974 and section 9815 of this Act, and other than applicable cost-sharing).
  • 26 U.S.C. § 9816(c)(4)(F)(i)(I)
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    (I) is not a party to such determination or an employee or agent of such a party;
  • 26 U.S.C. § 9826(b)(2)(B)(iv)
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    (iv) amounts paid directly or indirectly in rebates, fees, or any other type of compensation (as defined in section 408(b)(2)(B)(ii)(dd)(AA) of the Employee Retirement Income Security Act1 (29 U.S.C. 1108(b)(2)(B)(ii)(dd)(AA)) to brokerage firms, brokers, consultants, advisors, or any other individual or firm, for—
    (I) the referral of the group health plan’s business to an entity providing pharmacy benefit management services, including the identity of the recipient of such amounts;
    (II) consideration of the entity providing pharmacy benefit management services by the group health plan; or
    (III) the retention of the entity by the group health plan;
  • 26 U.S.C. § 9826(e)(6)
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    (6) The term “plan sponsor” has the meaning given such term in section 3(16)(B) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(16)(B)).
  • 26 U.S.C. § 9826(e)(8)
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    (8) The term “specified large employer” means, in connection with a group health plan established or maintained by a single employer, with respect to a calendar year or a plan year, as applicable, an employer who employed an average of at least 100 employees on business days during the preceding calendar year or plan year and who employs at least 1 employee on the first day of the calendar year or plan year.
  • 26 U.S.C. § 9826(e)(9)
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    (9) The term “specified large plan” means a group health plan established or maintained by a plan sponsor described in clause (ii) or (iii) of section 3(16)(B) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(16)(B)) that had an average of at least 100 participants on business days during the preceding calendar year or plan year, as applicable.
  • 26 U.S.C. § 9831(a)(2)
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    (2) other than with respect to section 9826, any group health plan for any plan year if, on the first day of such plan year, such plan has less than 2 participants who are current employees.
  • 26 U.S.C. § 9831(d)(2)(A)(ii)
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    (ii) is provided on the same terms to all eligible employees of the eligible employer.
  • 26 U.S.C. § 9831(d)(2)(B)(ii)
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    (ii) such arrangement provides, after the employee provides proof of coverage, for the payment of, or reimbursement of, an eligible employee for expenses for medical care (as defined in section 213(d)) incurred by the eligible employee or the eligible employee’s family members (as determined under the terms of the arrangement), and
  • 26 U.S.C. § 9831(d)(2)(B)(iii)
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    (iii) the amount of payments and reimbursements described in clause (ii) for any year do not exceed $4,950 ($10,000 in the case of an arrangement that also provides for payments or reimbursements for family members of the employee).
  • 26 U.S.C. § 9831(d)(2)(C)
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    (C) For purposes of subparagraph (A)(ii), an arrangement shall not fail to be treated as provided on the same terms to each eligible employee merely because the employee’s permitted benefit under such arrangement varies in accordance with the variation in the price of an insurance policy in the relevant individual health insurance market based on—
    (i) the age of the eligible employee (and, in the case of an arrangement which covers medical expenses of the eligible employee’s family members, the age of such family members), or
    (ii) the number of family members of the eligible employee the medical expenses of which are covered under such arrangement.
    The variation permitted under the preceding sentence shall be determined by reference to the same insurance policy with respect to all eligible employees.
  • 26 U.S.C. § 9831(d)(2)(C)(i)
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    (i) the age of the eligible employee (and, in the case of an arrangement which covers medical expenses of the eligible employee’s family members, the age of such family members), or
  • 26 U.S.C. § 9831(d)(2)(C)(ii)
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    (ii) the number of family members of the eligible employee the medical expenses of which are covered under such arrangement.
  • 26 U.S.C. § 9831(d)(3)(A)
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    (A) The term “eligible employee” means any employee of an eligible employer, except that the terms of the arrangement may exclude from consideration employees described in any clause of section 105(h)(3)(B) (applied by substituting “90 days” for “3 years” in clause (i) thereof).
  • 26 U.S.C. § 9831(d)(3)(B)(ii)
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    (ii) does not offer a group health plan to any of its employees.
  • 26 U.S.C. § 9831(d)(3)(C)
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    (C) The term “permitted benefit” means, with respect to any eligible employee, the maximum dollar amount of payments and reimbursements which may be made under the terms of the qualified small employer health reimbursement arrangement for the year with respect to such employee.
  • 26 U.S.C. § 9831(d)(4)(A)
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    (A) An employer funding a qualified small employer health reimbursement arrangement for any year shall, not later than 90 days before the beginning of such year (or, in the case of an employee who is not eligible to participate in the arrangement as of the beginning of such year, the date on which such employee is first so eligible), provide a written notice to each eligible employee which includes the information described in subparagraph (B).
  • 26 U.S.C. § 9831(d)(4)(B)(i)
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    (i) A statement of the amount which would be such eligible employee’s permitted benefit under the arrangement for the year.
  • 26 U.S.C. § 9831(d)(4)(B)(ii)
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    (ii) A statement that the eligible employee should provide the information described in clause (i) to any health insurance exchange to which the employee applies for advance payment of the premium assistance tax credit.
  • 26 U.S.C. § 9831(d)(4)(B)(iii)
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    (iii) A statement that if the employee is not covered under minimum essential coverage for any month the employee may be subject to tax under section 5000A for such month and reimbursements under the arrangement may be includible in gross income.
  • 26 U.S.C. § 9832(b)(2)
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    (2) The term “health insurance issuer” means an insurance company, insurance service, or insurance organization (including a health maintenance organization, as defined in paragraph (3)) which is licensed to engage in the business of insurance in a State and which is subject to State law which regulates insurance (within the meaning of section 514(b)(2) of the Employee Retirement Income Security Act of 1974, as in effect on the date of the enactment of this section). Such term does not include a group health plan.
  • 26 U.S.C. § 9832(d)(1)(B)
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    (B) Part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1161 et seq.), other than section 609 of such Act.

Citations to §101(j)

Citations to §101(j)(3)(A)

Citations to §101(j)(3)(B)(i)

Citations to §101(j)(5)(B)