Internal Revenue Code · 26 U.S.C.

§ 4376. Self-insured health plans

In force Text current through Public Law 119-121 (October 9, 2026) release point 119-121

Official text, no changes From the Office of the Law Revision Counsel, release point 119-121 (current through Public Law 119-121 (October 9, 2026)). Compare it with the official text at uscode.house.gov (external site).

Cite as 26 U.S.C. § 4376

At a glance

Read from the text, the source credit and the official notes. Not part of the law.

Status: In force
Added: March 23, 2010 by Pub. L. 111–148
Last amended: December 20, 2019 by Pub. L. 116–94
Amendments: 1 dated changes in the source credit
Length: 5 subsections · 553 words · about 2 min to read
Defines: 2 terms
Cross-references: cites 1; cited by 1 Code section and 1 other regulation
Regulations: 1 issued under this section

¶(a) Imposition of fee

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

¶(b) Liability for fee

¶(1) In general

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

¶(2) Plan sponsor For purposes of paragraph (1) the term “” means—

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

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

¶(C) in the case of—

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

¶(ii) a multiple employer welfare arrangement, or

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

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

¶(c) Applicable self-insured health plan For purposes of this section, the term “applicable self-insured health plan” means any plan for providing accident or health coverage if—

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

¶(2) such plan is established or maintained—

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

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

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

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

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

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

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

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

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

¶(e) Termination

This section shall not apply to plan years ending after September 30, 2029.

(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.)

Terms defined here

Where the text says “the term … means”. Select a term to jump to its definition.

applicable self-insured health plan § 4376(c)
plan sponsor § 4376(b)(2)

Regulations under this section

Treasury regulations (26 CFR) issued under § 4376

§ 46.4376-1 Fee on sponsors of self-insured health plans.

Cross-references

Computed from the citations in the text of Title 26 and 26 CFR.

Amendment history

From the source credit and the official notes, newest first.

December 20, 2019Amended by Pub. L. 116–94Parts changed in 2019: (e)
March 23, 2010Added by Pub. L. 111–148

Where it sits in the Code

Nearby sections

Official notes

Show the Law Revision Counsel's notes (amendments, effective dates)

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”.