---
kind: "section"
citation: "26 U.S.C. § 4376"
title: "26"
title_heading: "Internal Revenue Code"
number: "4376"
heading: "Self-insured health plans"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/26/4376"
units:
  - "Subtitle D — Miscellaneous Excise Taxes"
  - "Chapter 34 — Taxes on Certain Insurance Policies"
  - "Subchapter B — Insured and Self-Insured Health Plans"
---

# §4376. Self-insured health plans

- (a) **Imposition of fee—** In the case of any applicable self-[insured](/usc/26/4372.md?p=d) health plan for each plan year ending after September 30, 2012, there is hereby imposed a fee equal to $2 ($1 in the case of plan years ending during fiscal year 2013) multiplied by the average number of lives covered under the plan.
- (b) **Liability for fee—**
  - (1) **In general—** The fee imposed by [subsection (a)](#a) shall be paid by the plan sponsor.
  - (2) **Plan sponsor—** For purposes of [paragraph (1)](#b-1) the term “plan sponsor” means—
    - (A) the employer in the case of a plan established or maintained by a single employer,
    - (B) the [employee](/usc/26/101.md?p=i-3) organization in the case of a plan established or maintained by an [employee](/usc/26/101.md?p=i-3) organization,
    - (C) in the case of—
      - (i) a plan established or maintained by 2 or more employers or jointly by 1 or more employers and 1 or more [employee](/usc/26/101.md?p=i-3) organizations,
      - (ii) a multiple employer welfare arrangement, or
      - (iii) a voluntary [employees](/usc/26/101.md?p=i-3)’ beneficiary association described in [section 501(c)(9)](/usc/26/501.md?p=c-9), the association, committee, joint board of trustees, or other similar group of representatives of the parties who establish or maintain the plan, or
    - (D) the cooperative or association described in [subsection (c)(2)(F)](#c-2-F) in the case of a plan established or maintained by such a cooperative or association.
- (c) **Applicable self-insured health plan—** For purposes of this section, the term “applicable self-[insured](/usc/26/4372.md?p=d) health plan” means any plan for providing accident or health coverage if—
  - (1) any portion of such coverage is provided other than through an [insurance policy](/usc/26/4377.md?p=a-2), and
  - (2) such plan is established or maintained—
    - (A) by 1 or more employers for the benefit of their [employees](/usc/26/101.md?p=i-3) or former [employees](/usc/26/101.md?p=i-3),
    - (B) by 1 or more [employee](/usc/26/101.md?p=i-3) organizations for the benefit of their members or former members,
    - (C) jointly by 1 or more employers and 1 or more [employee](/usc/26/101.md?p=i-3) organizations for the benefit of [employees](/usc/26/101.md?p=i-3) or former [employees](/usc/26/101.md?p=i-3),
    - (D) by a voluntary [employees](/usc/26/101.md?p=i-3)’ beneficiary association described in [section 501(c)(9)](/usc/26/501.md?p=c-9),
    - (E) by any organization described in [section 501(c)(6)](/usc/26/501.md?p=c-6), or
    - (F) in the case of a plan not described in the preceding subparagraphs, by a multiple employer welfare arrangement (as defined in section 3(40) of [Employee](/usc/26/101.md?p=i-3) Retirement Income Security Act of 1974), a rural electric cooperative (as defined in [section 3(40)(B)(iv)](/usc/26/3.md) of such Act), or a rural telephone cooperative association (as defined in [section 3(40)(B)(v)](/usc/26/3.md) of such Act).
- (d) **Adjustments for increases in health care spending—** In the case of any plan year ending in any fiscal year beginning after September 30, 2014, the dollar amount in effect under [subsection (a)](#a) for such plan year shall be equal to the sum of such dollar amount for plan years ending in the previous fiscal year (determined after the application of this subsection), plus an amount equal to the product of—
  - (1) such dollar amount for plan years ending in the previous fiscal year, multiplied by
  - (2) the percentage increase in the projected per capita amount of National Health Expenditures, as most recently published by the Secretary before the beginning of the fiscal year.
- (e) **Termination—** This section shall not apply to plan years ending after September 30, 2029.

## Source credit

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

## Notes

### Editorial Notes

### References in Text

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

### Amendments

2019—Subsec. (e). Pub. L. 116–94 substituted “2029” for “2019”.