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26 U.S.C. § 45R — Employee health insurance expenses of small employers
Federal law — U.S. Code and appendices · legal_authorities
**(a) General rule** For purposes of section 38, in the case of an eligible small employer, the small employer health insurance credit determined under this section for any taxable year in the credit period is the amount determined under subsection (b).
**(b) Health insurance credit amount** Subject to subsection (c), the amount determined under this subsection with respect to any eligible small employer is equal to 50 percent (35 percent in the case of a tax-exempt eligible small employer) of the lesser of—
(1) the aggregate amount of nonelective contributions the employer made on behalf of its employees during the taxable year under the arrangement described in subsection (d)(4) for premiums for qualified health plans offered by the employer to its employees through an Exchange, or
(2) the aggregate amount of nonelective contributions which the employer would have made during the taxable year under the arrangement if each employee taken into account under paragraph (1) had enrolled in a qualified health plan which had a premium equal to the average premium (as determined by the Secretary of Health and Human Services) for the small group market in the rating area in which the employee enrolls for coverage.
**(c) Phaseout of credit amount based on number of employees and average wages** The amount of the credit determined under subsection (b) without regard to this subsection shall be reduced (but not below zero) by the sum of the following amounts:
(1) Such amount multiplied by a fraction the numerator of which is the total number of full-time equivalent employees of the employer in excess of 10 and the denominator of which is 15.
(2) Such amount multiplied by a fraction the numerator of which is the average annual wages of the employer in excess of the dollar am
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Source file: Laws/federal/codes/united-states-code/title-26/section-45r-employee-health-insurance-expenses-of-small-employers--018b3c04d7.md
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Source location: Title 26, Chapter 1, § 45R; chapter-001-normal-taxes-and-surtaxes.md
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**(a) General rule** For purposes of section 38, in the case of an eligible small employer, the small employer health insurance credit determined under this section for any taxable year in the credit period is the amount determined under subsection (b).
**(b) Health insurance credit amount** Subject to subsection (c), the amount determined under this subsection with respect to any eligible small employer is equal to 50 percent (35 percent in the case of a tax-exempt eligible small employer) of the lesser of—
(1) the aggregate amount of nonelective contributions the employer made on behalf of its employees during the taxable year under the arrangement described in subsection (d)(4) for premiums for qualified health plans offered by the employer to its employees through an Exchange, or
(2) the aggregate amount of nonelective contributions which the employer would have made during the taxable year under the arrangement if each employee taken into account under paragraph (1) had enrolled in a qualified health plan which had a premium equal to the average premium (as determined by the Secretary of Health and Human Services) for the small group market in the rating area in which the employee enrolls for coverage.
**(c) Phaseout of credit amount based on number of employees and average wages** The amount of the credit determined under subsection (b) without regard to this subsection shall be reduced (but not below zero) by the sum of the following amounts:
(1) Such amount multiplied by a fraction the numerator of which is the total number of full-time equivalent employees of the employer in excess of 10 and the denominator of which is 15.
(2) Such amount multiplied by a fraction the numerator of which is the average annual wages of the employer in excess of the dollar amount in effect under subsection (d)(3)(B) and the denominator of which is such dollar amount.
**(d) Eligible small employer** For purposes of this section—
(1) **In general** — The term “eligible small employer” means, with respect to any taxable year, an employer—
(A) which has no more than 25 full-time equivalent employees for the taxable year,
(B) the average annual wages of which do not exceed an amount equal to twice the dollar amount in effect under paragraph (3)(B) for the taxable year, and
(C) which has in effect an arrangement described in paragraph (4).
(2) **Full-time equivalent employees**
(A) *In general* — The term “full-time equivalent employees” means a number of employees equal to the number determined by dividing—
(i) the total number of hours of service for which wages were paid by the employer to employees during the taxable year, by
(ii) 2,080.
Such number shall be rounded to the next lowest whole number if not otherwise a whole number.
(B) *Excess hours not counted* — If an employee works in excess of 2,080 hours of service during any taxable year, such excess shall not be taken into account under subparagraph (A).
(C) *Hours of service* — 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.
(3) **Average annual wages**
(A) *In general* — The average annual wages of an eligible small employer for any taxable year is the amount determined by dividing—
(i) the aggregate amount of wages which were paid by the employer to employees during the taxable year, by
(ii) the number of full-time equivalent employees of the employee determined under paragraph (2) for the taxable year.
Such amount shall be rounded to the next lowest multiple of $1,000 if not otherwise such a multiple.
(B) *Dollar amount* — For purposes of paragraph (1)(B) and subsection (c)(2)—
(i) *2010, 2011, 2012, and 2013* — The dollar amount in effect under this paragraph for taxable years beginning in 2010, 2011, 2012, or 2013 is $25,000.
(ii) *Subsequent years* — In the case of a taxable year beginning in a calendar year after 2013, the dollar amount in effect under this paragraph shall be equal to $25,000, multiplied by the cost-of-living adjustment under section 1(f)(3) for the calendar year, determined by substituting “calendar year 2012” for “calendar year 2016” in subparagraph (A)(ii) thereof.
(4) **Contribution arrangement** — An arrangement is described in this paragraph if it requires an eligible small employer to make a nonelective contribution on behalf of each employee who enrolls in a qualified health plan offered to employees by the employer through an exchange in an amount equal to a uniform percentage (not less than 50 percent) of the premium cost of the qualified health plan.
(5) **Seasonal worker hours and wages not counted** — For purposes of this subsection—
(A) *In general* — The number of hours of service worked by, and wages paid to, a seasonal worker of an employer shall not be taken into account in determining the full-time equivalent employees and average annual wages of the employer unless the worker works for the employer on more than 120 days during the taxable year.
(B) *Definition of seasonal worker* — The term “seasonal worker” means a worker who performs labor or services on a seasonal basis as defined by the Secretary of Labor, including workers covered by section 500.20(s)(1) of title 29, Code of Federal Regulations and retail workers employed exclusively during holiday seasons.
**(e) Other rules and definitions** For purposes of this section—
(1) **Employee**
(A) *Certain employees excluded* — The term “employee” shall not include—
(i) an employee within the meaning of section 401(c)(1),
(ii) any 2-percent shareholder (as defined in section 1372(b)) of an eligible small business which is an S corporation,
(iii) any 5-percent owner (as defined in section 416(i)(1)(B)(i)) of an eligible small business, or
(iv) any individual who bears any of the relationships described in subparagraphs (A) through (G) of section 152(d)(2) to, or is a dependent described in section 152(d)(2)(H) of, an individual described in clause (i), (ii), or (iii).
(B) *Leased employees* — The term “employee” shall include a leased employee within the meaning of section 414(n).
(2) **Credit period** — The term “credit period” means, with respect to any eligible small employer, the 2-consecutive-taxable year period beginning with the 1st taxable year in which the employer (or any predecessor) offers 1 or more qualified health plans to its employees through an Exchange.
(3) **Nonelective contribution** — The term “nonelective contribution” means an employer contribution other than an employer contribution pursuant to a salary reduction arrangement.
(4) **Wages** — The term “wages” has the meaning given such term by section 3121(a) (determined without regard to any dollar limitation contained in such section).
(5) **Aggregation and other rules made applicable**
(A) *Aggregation rules* — All employers treated as a single employer under subsection (b), (c), (m), or (o) of section 414 shall be treated as a single employer for purposes of this section.
(B) *Other rules* — Rules similar to the rules of subsections (c), (d), and (e) of section 52 shall apply.
**(f) Credit made available to tax-exempt eligible small employers**
(1) **In general** — In the case of a tax-exempt eligible small employer, there shall be treated as a credit allowable under subpart C (and not allowable under this subpart) the lesser of—
(A) the amount of the credit determined under this section with respect to such employer, or
(B) the amount of the payroll taxes of the employer during the calendar year in which the taxable year begins.
(2) **Tax-exempt eligible small employer** — For purposes of this section, the term “tax-exempt eligible small employer” means an eligible small employer which is any organization described in section 501(c) which is exempt from taxation under section 501(a).
(3) **Payroll taxes** — For purposes of this subsection—
(A) *In general* — The term “payroll taxes” means—
(i) amounts required to be withheld from the employees of the tax-exempt eligible small employer under section 3401(a),
(ii) amounts required to be withheld from such employees under section 3101(b), and
(iii) amounts of the taxes imposed on the tax-exempt eligible small employer under section 3111(b).
(B) *Special rule* — A rule similar to the rule of section 24(d)(2)(C) shall apply for purposes of subparagraph (A).
**(g) Application of section for calendar years 2010, 2011, 2012, and 2013** In the case of any taxable year beginning in 2010, 2011, 2012, or 2013, the following modifications to this section shall apply in determining the amount of the credit under subsection (a):
(1) **No credit period required** — The credit shall be determined without regard to whether the taxable year is in a credit period and for purposes of applying this section to taxable years beginning after 2013, no credit period shall be treated as beginning with a taxable year beginning before 2014.
(2) **Amount of credit** — The amount of the credit determined under subsection (b) shall be determined—
(A) by substituting “35 percent (25 percent in the case of a tax-exempt eligible small employer)” for “50 percent (35 percent in the case of a tax-exempt eligible small employer)”,
(B) by reference to an eligible small employer’s nonelective contributions for premiums paid for health insurance coverage (within the meaning of section 9832(b)(1)) of an employee, and
(C) by substituting for the average premium determined under subsection (b)(2) the amount the Secretary of Health and Human Services determines is the average premium for the small group market in the State in which the employer is offering health insurance coverage (or for such area within the State as is specified by the Secretary).
(3) **Contribution arrangement** — An arrangement shall not fail to meet the requirements of subsection (d)(4) solely because it provides for the offering of insurance outside of an Exchange.
**(h) Insurance definitions** Any term used in this section which is also used in the Public Health Service Act or subtitle A of title I of the Patient Protection and Affordable Care Act shall have the meaning given such term by such Act or subtitle.
**(i) Regulations** The Secretary shall prescribe such regulations as may be necessary to carry out the provisions of this section, including regulations to prevent the avoidance of the 2-year limit on the credit period through the use of successor entities and the avoidance of the limitations under subsection (c) through the use of multiple entities.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** Not later than 90 days after March 23, 2010, the Secretary shall establish a temporary high risk health insurance pool program to provide health insurance coverage for eligible individuals during the period beginning on the date on which such program is established and ending on January 1, 2014.
**(b) Administration**
(1) **In general** — The Secretary may carry out the program under this section directly or through contracts to eligible entities.
(2) **Eligible entities** — To be eligible for a contract under paragraph (1), an entity shall—
(A) be a State or nonprofit private entity;
(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; and
(C) agree to utilize contract funding to establish and administer a qualified high risk pool for eligible individuals.
(3) **Maintenance of effort** — To be eligible to enter into a contract with the Secretary under this subsection, a State shall agree not to reduce the annual amount the State expended for the operation of one or more State high risk pools during the year preceding the year in which such contract is entered into.
**(c) Qualified high risk pool**
(1) **In general** — Amounts made available under this section shall be used to establish a qualified high risk pool that meets the requirements of paragraph (2).
(2) **Requirements** — A qualified high risk pool meets the requirements of this paragraph if such pool—
(A) provides to all eligible individuals health insurance coverage that does not impose any preexisting condition exclusion with respect to such coverage;
(B) provides health insurance coverage—
(i) in which the issuer’s share of the total allowed costs of benefits provided under such co
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18001
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Prohibition**
(1) **In general** — A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish—
(A) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
(B) except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary.
(2) **Annual limits prior to 2014** — With respect to plan years beginning prior to January 1, 2014, a group health plan and a health insurance issuer offering group or individual health insurance coverage may only establish a restricted annual limit on the dollar value of benefits for any participant or beneficiary with respect to the scope of benefits that are essential health benefits under [section 18022(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18022/b&num=0&edition=prelim), as determined by the Secretary. In defining the term “restricted annual limit” for purposes of the preceding sentence, the Secretary shall ensure that access to needed services is made available with a minimal impact on premiums.
**(b) Per beneficiary limits** Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage from placing annual or lifetime per beneficiary limits on specific covered benefits that are not essential health benefits under [section 18022(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18022/b&num=0&edition=prelim), to the extent that such limits are otherwise permitted under Federal or State law.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 300gg–11
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Disclosure of information by health plan issuers** In connection with the offering of any health insurance coverage to a small employer or an individual, a health insurance issuer—
(1) shall make a reasonable disclosure to such employer, or individual, as applicable,,11 So in original. as part of its solicitation and sales materials, of the availability of information described in subsection (b), and
(2) upon request of such a 22 So in original. Probably should be “an”. employer, or individual, as applicable,,1 provide such information.
**(b) Information described**
(1) **In general** — Subject to paragraph (3), with respect to a health insurance issuer offering health insurance coverage to a 2 employer, or individual, as applicable,,1 information described in this subsection is information concerning—
(A) the provisions of such coverage concerning issuer’s right to change premium rates and the factors that may affect changes in premium rates; and
(B) the benefits and premiums available under all health insurance coverage for which the employer, or individual, as applicable, is qualified.
(2) **Form of information** — Information under this subsection shall be provided to employers, or individuals, as applicable, in a manner determined to be understandable by the average employer, or individual, as applicable,,1 and shall be sufficient to reasonably inform employers, or individuals, as applicable, of their rights and obligations under the health insurance coverage.
(3) **Exception** — An issuer is not required under this section to disclose any information that is proprietary and trade secret information under applicable law.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 300gg–9
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Married individuals filing joint returns and surviving spouses** There is hereby imposed on the taxable income of—
(1) every married individual (as defined in section 7703) who makes a single return jointly with his spouse under section 6013, and
(2) every surviving spouse (as defined in section 2(a)),
a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $36,90015% of taxable income. Over $36,900 but not over $89,150$5,535, plus 28% of the excess over $36,900. Over $89,150 but not over $140,000$20,165, plus 31% of the excess over $89,150. Over $140,000 but not over $250,000$35,928.50, plus 36% of the excess over $140,000. Over $250,000$75,528.50, plus 39.6% of the excess over $250,000.
**(b) Heads of households** There is hereby imposed on the taxable income of every head of a household (as defined in section 2(b)) a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $29,60015% of taxable income. Over $29,600 but not over $76,400$4,440, plus 28% of the excess over $29,600. Over $76,400 but not over $127,500$17,544, plus 31% of the excess over $76,400. Over $127,500 but not over $250,000$33,385, plus 36% of the excess over $127,500. Over $250,000$77,485, plus 39.6% of the excess over $250,000.
**(c) Unmarried individuals (other than surviving spouses and heads of households)** There is hereby imposed on the taxable income of every individual (other than a surviving spouse as defined in section 2(a) or the head of a household as defined in section 2(b)) who is not a married individual (as defined in section 7703) a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $22,10015% of taxable income. Over $22,100 but not over $53,50
Source: Supplied U.S. Code snapshot — release unconfirmed · 26 U.S.C. § 1
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Federal law — U.S. Code and appendices · legal_authorities
Beginning with fiscal year 2010, the Secretary shall transfer from the Public Health and Social Services Emergency Fund such sums as may be necessary to carry out this part.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 201
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage for and shall not impose any cost sharing requirements for—
(1) evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force;
(2) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved; and 11 So in original.
(3) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration.1
(4) with respect to women, such additional preventive care and screenings not described in paragraph (1) as provided for in comprehensive guidelines supported by the Health Resources and Services Administration for purposes of this paragraph.1
(5) for the purposes of this chapter, and for the purposes of any other provision of law, the current recommendations of the United States Preventive Service Task Force regarding breast cancer screening, mammography, and prevention shall be considered the most current other than those issued in or around November 2009.
Nothing in this subsection shall be construed to prohibit a plan or issuer from providing coverage for services in addition to those recommended by United States Preventive Services Task Force or to deny coverage for services that are not recommended by such Task Force.
**(b) Interval**
(1) **In general** — The Secretary shall establish a minimum interval between the date on which a recommendation descr
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 300gg–13
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Allowance of credit** There shall be allowed as a credit against the tax imposed by this chapter for the taxable year an amount equal to the sum of—
(1) the business credit carryforwards carried to such taxable year,
(2) the amount of the current year business credit, plus
(3) the business credit carrybacks carried to such taxable year.
**(b) Current year business credit** For purposes of this subpart, the amount of the current year business credit is the sum of the following credits determined for the taxable year:
(1) the investment credit determined under section 46,
(2) the work opportunity credit determined under section 51(a),
(3) the alcohol fuels credit determined under section 40(a),
(4) the research credit determined under section 41(a),
(5) the low-income housing credit determined under section 42(a),
(6) the enhanced oil recovery credit under section 43(a),
(7) in the case of an eligible small business (as defined in section 44(b)), the disabled access credit determined under section 44(a),
(8) the renewable electricity production credit under section 45(a),
(9) the empowerment zone employment credit determined under section 1396(a),
(10) the Indian employment credit as determined under section 45A(a),
(11) the employer social security credit determined under section 45B(a),
(12) the orphan drug credit determined under section 45C(a),
(13) the new markets tax credit determined under section 45D(a),
(14) in the case of an eligible employer (as defined in section 45E(c)), the small employer pension plan startup cost credit determined under section 45E(a),
(15) the employer-provided child care credit determined under section 45F(a),
(16) the railroad track maintenance credit determined under section 45G(a),
(17) the biodiesel fuels cr
Source: Supplied U.S. Code snapshot — release unconfirmed · 26 U.S.C. § 38
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Internet portal to affordable coverage options**
(1) **Immediate establishment** — Not later than July 1, 2010, the Secretary, in consultation with the States, shall establish a mechanism, including an Internet website, through which a resident of, or small business in, any State may identify affordable health insurance coverage options in that State.
(2) **Connecting to affordable coverage** — An Internet website established under paragraph (1) shall, to the extent practicable, provide ways for residents of, and small businesses in, any State to receive information on at least the following coverage options:
(A) Health insurance coverage offered by health insurance issuers, other than coverage that provides reimbursement only for the treatment or mitigation of—
(i) a single disease or condition; or
(ii) an unreasonably limited set of diseases or conditions (as determined by the Secretary).
(B) Medicaid coverage under title XIX of the Social Security Act [[42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq.].
(C) Coverage under title XXI of the Social Security Act [[42 U.S.C. 1397aa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397aa&num=0&edition=prelim) et seq.].
(D) A State health benefits high risk pool, to the extent that such high risk pool is offered in such State; and
(E) Coverage under a high risk pool under [section 18001 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18001&num=0&edition=prelim).
(F) Coverage within the small group market for small businesses and their employees, including reinsurance for early retirees under [section 18002 of this title](https://uscode.house.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18003
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Federal law — U.S. Code and appendices · legal_authorities
Page 301
TITLE 26—INTERNAL REVENUE CODE
§ 45R
2022—Internal Revenue Notice 2022–38.
2021—Internal Revenue Notice 2021–35.
2020—Internal Revenue Notice 2020–40.
2019—Internal Revenue Notice 2019–31.
2018—Internal Revenue Notice 2018–40.
2017—Internal Revenue Notice 2017–32.
2016—Internal Revenue Notice 2016–53.
2015—Internal Revenue Notice 2015–44.
2014—Internal Revenue Notice 2014–40.
2013—Internal Revenue Notice 2013–34.
2012—Internal Revenue Notice 2012—42.
2011—Internal Revenue Notice 2011–50.
2010—Internal Revenue Notice 2010–75.
§ 45R. Employee health insurance expenses of
small employers
(a) General rule
For purposes of section 38, in the case of an el-
igible small employer, the small employer
health insurance credit determined under this
section for any taxable year in the credit period
is the amount determined under subsection (b).
(b) Health insurance credit amount
Subject to subsection (c), the amount deter-
mined under this subsection with respect to any
eligible small employer is equal to 50 percent (35
percent in the case of a tax-exempt eligible
small employer) of the lesser of—
(1) the aggregate amount of nonelective con-
tributions the employer made on behalf of its
employees during the taxable year under the
arrangement described in subsection (d)(4) for
premiums for qualified health plans offered by
the employer to its employees through an Ex-
change, or
(2) the aggregate amount of nonelective con-
tributions which the employer would have
made during the taxable year under the ar-
rangement if each employee taken into ac-
count under paragraph (1) had enrolled in a
qualified health plan which had a premium
equal to the average premium (as determined
by the Secretary of Health and Human Serv-
ices) for the small group
Source: Supplied 2024 U.S. Code historical extraction · 26 U.S.C. § 45R
Stored review status: historical_2024_not_currentness_verified. Same stored citation; legal effect and authority still require review.