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29 U.S.C. § 1167 — Definitions and special rules
Federal law — U.S. Code and appendices · legal_authorities
For purposes of this part—
(1) **Group health plan** — The term “group health plan” means an employee welfare benefit plan providing medical care (as defined in [section 213(d) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section213/d&num=0&edition=prelim)) to participants or beneficiaries directly or through insurance, reimbursement, or otherwise. Such term shall not include any plan substantially all of the coverage under which is for qualified long-term care services (as defined in [section 7702B(c) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section7702B/c&num=0&edition=prelim)). Such term shall not include any qualified small employer health reimbursement arrangement (as defined in [section 9831(d)(2) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section9831/d/2&num=0&edition=prelim)).
(2) **Covered employee** — 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) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section401/c/1&num=0&edition=prelim)).
(3) **Qualified beneficiary**
(A) *In general* — 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 em
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Source location: Title 29, Chapter 18, § 1167; chapter-018-employee-retirement-income-security-program.md
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For purposes of this part—
(1) **Group health plan** — The term “group health plan” means an employee welfare benefit plan providing medical care (as defined in [section 213(d) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section213/d&num=0&edition=prelim)) to participants or beneficiaries directly or through insurance, reimbursement, or otherwise. Such term shall not include any plan substantially all of the coverage under which is for qualified long-term care services (as defined in [section 7702B(c) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section7702B/c&num=0&edition=prelim)). Such term shall not include any qualified small employer health reimbursement arrangement (as defined in [section 9831(d)(2) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section9831/d/2&num=0&edition=prelim)).
(2) **Covered employee** — 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) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section401/c/1&num=0&edition=prelim)).
(3) **Qualified beneficiary**
(A) *In general* — 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 part.
(B) *Special rule for terminations and reduced employment* — In the case of a qualifying event described in [section 1163(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1163/2&num=0&edition=prelim), the term “qualified beneficiary” includes the covered employee.
(C) *Special rule for retirees and widows* — In the case of a qualifying event described in [section 1163(6) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1163/6&num=0&edition=prelim), 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 employee, or
(iii) as the surviving spouse of the covered employee.
(4) **Employer** — Subsection (n) (relating to leased employees) and subsection (t) (relating to application of controlled group rules to certain employee benefits) of [section 414 of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section414&num=0&edition=prelim) shall apply for purposes of this part in the same manner and to the same extent as such subsections apply for purposes of [section 106 of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section106&num=0&edition=prelim). Any regulations prescribed by the Secretary pursuant to the preceding sentence shall be consistent and coextensive with any regulations prescribed for similar purposes by the Secretary of the Treasury (or such Secretary’s delegate) under such subsections.
(5) **Optional extension of required periods** — A group health plan shall not be treated as failing to meet the requirements of this part solely because the plan provides both—
(A) that the period of extended coverage referred to in [section 1162(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1162/2&num=0&edition=prelim) commences with the date of the loss of coverage, and
(B) that the applicable notice period provided under [section 1166(a)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1166/a/2&num=0&edition=prelim) commences with the date of the loss of coverage.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** For purposes of this title—
(1) a qualified long-term care insurance contract shall be treated as an accident and health insurance contract,
(2) amounts (other than policyholder dividends, as defined in section 808, or premium refunds) received under a qualified long-term care insurance contract shall be treated as amounts received for personal injuries and sickness and shall be treated as reimbursement for expenses actually incurred for medical care (as defined in section 213(d)),
(3) any plan of an employer providing coverage under a qualified long-term care insurance contract shall be treated as an accident and health plan with respect to such coverage,
(4) except as provided in subsection (e)(3), amounts paid for a qualified long-term care insurance contract providing the benefits described in subsection (b)(2)(A) shall be treated as payments made for insurance for purposes of section 213(d)(1)(D), and
(5) a qualified long-term care insurance contract shall be treated as a guaranteed renewable contract subject to the rules of section 816(e).
**(b) Qualified long-term care insurance contract** For purposes of this title—
(1) **In general** — The term “qualified long-term care insurance contract” means any insurance contract if—
(A) the only insurance protection provided under such contract is coverage of qualified long-term care services,
(B) such contract does not pay or reimburse expenses incurred for services or items to the extent that such expenses are reimbursable under title XVIII of the Social Security Act or would be so reimbursable but for the application of a deductible or coinsurance amount,
(C) such contract is guaranteed renewable,
(D) such contract does not provide for a cash surrender value or other money that can
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Group health plan** For purposes of this part—
(1) **In general** — The term “group health plan” means an employee welfare benefit plan to the extent that the plan provides medical care (as defined in paragraph (2) and including items and services paid for as medical care) to employees or their dependents (as defined under the terms of the plan) directly or through insurance, reimbursement, or otherwise. Such term shall not include any qualified small employer health reimbursement arrangement (as defined in [section 9831(d)(2) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section9831/d/2&num=0&edition=prelim)).
(2) **Medical care** — The term “medical care” means amounts paid for—
(A) the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body,
(B) amounts paid for transportation primarily for and essential to medical care referred to in subparagraph (A), and
(C) amounts paid for insurance covering medical care referred to in subparagraphs (A) and (B).
**(b) Definitions relating to health insurance** For purposes of this part—
(1) **Health insurance coverage** — The term “health insurance coverage” means benefits consisting of medical care (provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as medical care) under any hospital or medical service policy or certificate, hospital or medical service plan contract, or health maintenance organization contract offered by a health insurance issuer.
(2) **Health insurance issuer** — The term “health insurance issuer” means an insurance company, insurance service, or insurance organization (including a health maintenance organ
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Federal law — U.S. Code and appendices · legal_authorities
**(a) General rule** Except as otherwise provided in this section, gross income of an employee does not include employer-provided coverage under an accident or health plan.
**(b) Contributions to Archer MSAs**
(1) **In general** — In the case of an employee who is an eligible individual, amounts contributed by such employee’s employer to any Archer MSA of such employee shall be treated as employer-provided coverage for medical expenses under an accident or health plan to the extent such amounts do not exceed the limitation under section 220(b)(1) (determined without regard to this subsection) which is applicable to such employee for such taxable year.
(2) **No constructive receipt** — No amount shall be included in the gross income of any employee solely because the employee may choose between the contributions referred to in paragraph (1) and employer contributions to another health plan of the employer.
(3) **Special rule for deduction of employer contributions** — Any employer contribution to an Archer MSA, if otherwise allowable as a deduction under this chapter, shall be allowed only for the taxable year in which paid.
(4) **Employer MSA contributions required to be shown on return** — Every individual required to file a return under section 6012 for the taxable year shall include on such return the aggregate amount contributed by employers to the Archer MSAs of such individual or such individual’s spouse for such taxable year.
(5) **MSA contributions not part of COBRA coverage** — Paragraph (1) shall not apply for purposes of section 4980B.
(6) **Definitions** — For purposes of this subsection, the terms “eligible individual” and “Archer MSA” have the respective meanings given to such terms by section 220.
(7) **Cross reference** — For penalty on failure b
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Federal law — U.S. Code and appendices · legal_authorities
**(a) General rule** There is hereby imposed a tax on the failure of a group health plan to meet the requirements of subsection (f) with respect to any qualified beneficiary.
**(b) Amount of tax**
(1) **In general** — The amount of the tax imposed by subsection (a) on any failure with respect to a qualified beneficiary shall be $100 for each day in the noncompliance period with respect to such failure.
(2) **Noncompliance period** — For purposes of this section, the term “noncompliance period” means, with respect to any failure, the period—
(A) beginning on the date such failure first occurs, and
(B) ending on the earlier of—
(i) the date such failure is corrected, or
(ii) the date which is 6 months after the last day in the period applicable to the qualified beneficiary under subsection (f)(2)(B) (determined without regard to clause (iii) thereof).
If a person is liable for tax under subsection (e)(1)(B) by reason of subsection (e)(2)(B) with respect to any failure, the noncompliance period for such person with respect to such failure shall not begin before the 45th day after the written request described in subsection (e)(2)(B) is provided to such person.
(3) **Minimum tax for noncompliance period where failure discovered after notice of examination** — Notwithstanding paragraphs (1) and (2) of subsection (c)—
(A) *In general* — In the case of 1 or more failures with respect to a qualified beneficiary—
(i) which are not corrected before the date a notice of examination of income tax liability is sent to the employer, and
(ii) which occurred or continued during the period under examination,
the amount of tax imposed by subsection (a) by reason of such failures with respect to such beneficiary shall not be less than the lesser of $
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** There shall be allowed as a deduction all the ordinary and necessary expenses paid or incurred during the taxable year in carrying on any trade or business, including—
(1) a reasonable allowance for salaries or other compensation for personal services actually rendered;
(2) traveling expenses (including amounts expended for meals and lodging other than amounts which are lavish or extravagant under the circumstances) while away from home in the pursuit of a trade or business; and
(3) rentals or other payments required to be made as a condition to the continued use or possession, for purposes of the trade or business, of property to which the taxpayer has not taken or is not taking title or in which he has no equity.
For purposes of the preceding sentence, the place of residence of a Member of Congress (including any Delegate and Resident Commissioner) within the State, congressional district, or possession which he represents in Congress shall be considered his home, but amounts expended by such Members within each taxable year for living expenses shall not be deductible for income tax purposes. For purposes of paragraph (2), the taxpayer shall not be treated as being temporarily away from home during any period of employment if such period exceeds 1 year. The preceding sentence shall not apply to any Federal employee during any period for which such employee is certified by the Attorney General (or the designee thereof) as traveling on behalf of the United States in temporary duty status to investigate or prosecute, or provide support services for the investigation or prosecution of, a Federal crime.
**(b) Charitable contributions and gifts excepted** No deduction shall be allowed under subsection (a) for any contribution or gift which would be al
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Federal law — U.S. Code and appendices · legal_authorities
### Statutory Notes
Section, added Pub. L. 99–514, title XI, § 1151(a), Oct. 22, 1986, 100 Stat. 2494; amended Pub. L. 100–647, title I, § 1011B(a)(1)–(9), (21), (28), (29), (34), title III, § 3021(a)(1)(A), (B), (2)(A), (3)–(9), (11)–(13)(A), (b)(2)(B), (3), title VI, § 6051(a), Nov. 10, 1988, 102 Stat. 3483–3485, 3487, 3488, 3625–3632, 3695, related to nondiscrimination rules regarding benefits provided under employee benefit plans.
#### Effective Date of Repeal
Pub. L. 101–140, title II, § 202(c), Nov. 8, 1989, 103 Stat. 830, provided that: “The amendments made by this section [repealing this section] shall take effect as if included in section 1151 of the Tax Reform Act of 1986 [Pub. L. 99–514, see section 1151(k) set out as a note under [section 79 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section79&num=0&edition=prelim)].”
#### Nonenforcement of Section for Fiscal Year 1990
Pub. L. 101–136, title V, § 528, Nov. 3, 1989, 103 Stat. 816, provided that: “No monies appropriated by this Act [see Tables for classification] may be used to implement or enforce section 1151 of the Tax Reform Act of 1986 or the amendments made by such section [section 1151 of Pub. L. 99–514, which enacted [section 89 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section89&num=0&edition=prelim), amended sections 79, 105, 106, 117, 120, 125, 127, 129, 132, 414, 505, 3121, 3306, 6039D, and 6652 of this title and [section 409 of Title 42](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section409&num=0&edition=prelim), The Public Health and Welfare, and enacted provisions set out as a note under [section 89 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-sec
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Requirements for qualification** A trust created or organized in the United States and forming part of a stock bonus, pension, or profit-sharing plan of an employer for the exclusive benefit of his employees or their beneficiaries shall constitute a qualified trust under this section—
(1) if contributions are made to the trust by such employer, or employees, or both, or by another employer who is entitled to deduct his contributions under section 404(a)(3)(B) (relating to deduction for contributions to profit-sharing and stock bonus plans), or by a charitable remainder trust pursuant to a qualified gratuitous transfer (as defined in section 664(g)(1)), for the purpose of distributing to such employees or their beneficiaries the corpus and income of the fund accumulated by the trust in accordance with such plan;
(2) if under the trust instrument it is impossible, at any time prior to the satisfaction of all liabilities with respect to employees and their beneficiaries under the trust, for any part of the corpus or income to be (within the taxable year or thereafter) used for, or diverted to, purposes other than for the exclusive benefit of his employees or their beneficiaries (but this paragraph shall not be construed, in the case of a multiemployer plan, to prohibit the return of a contribution within 6 months after the plan administrator determines that the contribution was made by a mistake of fact or law (other than a mistake relating to whether the plan is described in section 401(a) or the trust which is part of such plan is exempt from taxation under section 501(a), or the return of any withdrawal liability payment determined to be an overpayment within 6 months of such determination));
(3) if the plan of which such trust is a part satisfies the requireme
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Service for predecessor employer** For purposes of this part—
(1) in any case in which the employer maintains a plan of a predecessor employer, service for such predecessor shall be treated as service for the employer, and
(2) in any case in which the employer maintains a plan which is not the plan maintained by a predecessor employer, service for such predecessor shall, to the extent provided in regulations prescribed by the Secretary, be treated as service for the employer.
**(b) Employees of controlled group of corporations**
(1) **In general** — For purposes of sections 401, 408(k), 408(p), 410, 411, 415, and 416, all employees of all corporations which are members of a controlled group of corporations (within the meaning of section 1563(a), determined without regard to section 1563(a)(4) and (e)(3)(C)) shall be treated as employed by a single employer. With respect to a plan adopted by more than one such corporation, the applicable limitations provided by section 404(a) shall be determined as if all such employers were a single employer, and allocated to each employer in accordance with regulations prescribed by the Secretary.
(2) **Special rules for applying family attribution** — For purposes of applying the attribution rules under section 1563 with respect to paragraph (1), the following rules apply:
(A) Community property laws shall be disregarded for purposes of determining ownership.
(B) Except as provided by the Secretary, stock of an individual not attributed under section 1563(e)(5) to such individual’s spouse shall not be attributed to such spouse by reason of the combined application of paragraphs (1) and (6)(A) of section 1563(e).
(C) Except as provided by the Secretary, in the case of stock in different corporations that is attribut
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Federal law — U.S. Code and appendices · legal_authorities
For purposes of this subchapter:
(1) The terms “employee welfare benefit plan” and “welfare plan” mean any plan, fund, or program which was heretofore or is hereafter established or maintained by an employer or by an employee organization, or by both, to the extent that such plan, fund, or program was established or is maintained for the purpose of providing for its participants or their beneficiaries, through the purchase of insurance or otherwise, (A) medical, surgical, or hospital care or benefits, or benefits in the event of sickness, accident, disability, death or unemployment, or vacation benefits, apprenticeship or other training programs, or day care centers, scholarship funds, or prepaid legal services, or (B) any benefit described in [section 186(c) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section186/c&num=0&edition=prelim) (other than pensions on retirement or death, and insurance to provide such pensions).
(2)
(A) Except as provided in subparagraph (B), the terms “employee pension benefit plan” and “pension plan” mean any plan, fund, or program which was heretofore or is hereafter established or maintained by an employer or by an employee organization, or by both, to the extent that by its express terms or as a result of surrounding circumstances such plan, fund, or program—
(i) provides retirement income to employees, or
(ii) results in a deferral of income by employees for periods extending to the termination of covered employment or beyond,
regardless of the method of calculating the contributions made to the plan, the method of calculating the benefits under the plan or the method of distributing benefits from the plan. A distribution from a plan, fund, or program shall not be treated as made
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Federal law — U.S. Code and appendices · legal_authorities
Page 564
TITLE 29—LABOR
§ 1167
fied beneficiary as the spouse of the covered em-
ployee shall be treated as notification to all
other qualified beneficiaries residing with such
spouse at the time such notification is made.
(Pub. L. 93–406, title I, § 606, as added Pub. L.
99–272, title X, § 10002(a), Apr. 7, 1986, 100 Stat.
230; amended Pub. L. 99–509, title IX, § 9501(d)(2),
Oct. 21, 1986, 100 Stat. 2077; Pub. L. 99–514, title
XVIII, § 1895(d)(6)(B), Oct. 22, 1986, 100 Stat. 2939;
Pub. L. 101–239, title VI, § 6703(c), title VII,
§ 7891(d)(1)(A), Dec. 19, 1989, 103 Stat. 2296, 2445;
Pub. L. 104–191, title IV, § 421(b)(2), Aug. 21, 1996,
110 Stat. 2088.)
Editorial Notes
REFERENCES IN TEXT
The Social Security Act, referred to in subsec. (a)(3),
is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Ti-
tles II and XVI of the Social Security Act are classified
generally to subchapters II (§ 401 et seq.) and XVI (§ 1381
et seq.), respectively, of chapter 7 of Title 42, The Pub-
lic Health and Welfare. For complete classification of
this Act to the Code, see section 1305 of Title 42 and Ta-
bles.
AMENDMENTS
1996—Subsec. (a)(3). Pub. L. 104–191 substituted ‘‘at
any time during the first 60 days of continuation cov-
erage under this part’’ for ‘‘at the time of a qualifying
event described in section 1163(2) of this title’’.
1989—Pub. L. 101–239, § 7891(d)(1)(A)(ii), designated
first sentence as subsec. (a), added subsec. (b), des-
ignated second sentence as subsec. (c), and substituted
‘‘For purposes of subsection (a)(4)’’ for ‘‘For purposes of
paragraph (4)’’.
Pub. L. 101–239, § 7891(d)(1)(A)(i)(II), inserted in last
sentence ‘‘(or, in the case of a group health plan which
is a multiemployer plan, such longer period of time as
may be provided in
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