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26 U.S.C. § 5000 — Certain group health plans
Federal law — U.S. Code and appendices · legal_authorities
**(a) Imposition of tax** 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.
**(b) Group health plan and large group health plan** For purposes of this section—
(1) **Group health plan** — 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.
(2) **Large group health plan** — 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 trea
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Source location: Title 26, Chapter 47, § 5000; chapter-047-certain-group-health-plans.md
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**(a) Imposition of tax** 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.
**(b) Group health plan and large group health plan** For purposes of this section—
(1) **Group health plan** — 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.
(2) **Large group health plan** — 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).
**(c) Nonconforming group health plan** For purposes of this section, the term “nonconforming group health plan” means a group health plan or large group health plan that at any time during a calendar year does not comply with the requirements of subparagraphs (A) and (C) or subparagraph (B), respectively, of paragraph (1), or with the requirements of paragraph (2), of section 1862(b) of the Social Security Act.
**(d) Government entities** For purposes of this section, the term “employer” does not include a Federal or other governmental entity.
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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
Source: Supplied U.S. Code snapshot — release unconfirmed · 26 U.S.C. § 162
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Federal law — U.S. Code and appendices · legal_authorities
With respect to covered part D drugs that would be applicable drugs (as defined in [section 1395w–114c(g)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395w–114c/g/2&num=0&edition=prelim)) but for the application of subparagraph (B) of such section, the Secretary shall provide a process whereby, in the case of an applicable beneficiary (as defined in [section 1395w–114c(g)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395w–114c/g/1&num=0&edition=prelim)) who, with respect to a year, is enrolled in a prescription drug plan or is enrolled in an MA–PD plan, has not incurred costs that are equal to or exceed the annual out-of-pocket threshold specified in [section 1395w–102(b)(4)(B)(i) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395w–102/b/4/B/i&num=0&edition=prelim), and is dispensed such a drug, the Secretary (periodically and on a timely basis) provides the PDP sponsor or the MA organization offering the plan, a subsidy with respect to such drug that is equal to 10 percent of the negotiated price (as defined in [section 1395w–114c(g)(6) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395w–114c/g/6&num=0&edition=prelim)) of such drug.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395y
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Prohibition on Financial Incentives Not to Enroll in a Group Health Plan.—**
(1) Except as provided in this subsection, the provisions of section 1862(b)(3)(C) of the Social Security Act shall apply with respect to financial or other incentives for a TRICARE-eligible employee not to enroll (or to terminate enrollment) under a health plan which would (in the case of such enrollment) be a primary plan under sections 1079(j)(1) 11 See References in Text note below. and 1086(g) of this title in the same manner as such section 1862(b)(3)(C) applies to financial or other incentives for an individual entitled to benefits under title XVIII of the Social Security Act not to enroll (or to terminate enrollment) under a group health plan or a large group health plan which would (in the case of enrollment) be a primary plan (as defined in section 1862(b)(2)(A) of such Act).
(2)
(A) The Secretary of Defense may by regulation adopt such additional exceptions to the prohibition referenced and applied under paragraph (1) as the Secretary deems appropriate and such paragraph (1) shall be implemented taking into account the adoption of such exceptions.
(B) The Secretary of Defense and the Secretary of Health and Human Services are authorized to enter into agreements for carrying out this subsection. Any such agreement shall provide that any expenses incurred by the Secretary of Health and Human Services pertaining to carrying out this subsection shall be reimbursed by the Secretary of Defense.
(C) Authorities of the Inspector General of the Department of Defense shall be available for oversight and investigations of responsibilities of employers and other entities under this subsection.
(D) Information obtained under [section 1095(k) of this title](https://uscode.house
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Items or services specifically excluded** Notwithstanding any other provision of this subchapter, no payment may be made under part A or part B for any expenses incurred for items or services—
(1)
(A) which, except for items and services described in a succeeding subparagraph or additional preventive services (as described in [section 1395x(ddd)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/ddd/1&num=0&edition=prelim)), are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member,
(B) in the case of items and services described in [section 1395x(s)(10) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/s/10&num=0&edition=prelim), which are not reasonable and necessary for the prevention of illness,
(C) in the case of hospice care, which are not reasonable and necessary for the palliation or management of terminal illness,
(D) in the case of clinical care items and services provided with the concurrence of the Secretary and with respect to research and experimentation conducted by, or under contract with, the Medicare Payment Advisory Commission or the Secretary, which are not reasonable and necessary to carry out the purposes of [section 1395ww(e)(6) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395ww/e/6&num=0&edition=prelim),11 See References in Text note below.
(E) in the case of research conducted pursuant to [section 1320b–12 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b-12&num=0&edition=prelim), which is not reasonable and necessary to carry out the purposes of that sec
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Federal law — U.S. Code and appendices · legal_authorities
Page 3125
TITLE 26—INTERNAL REVENUE CODE
§ 5000
Section 4994, added Pub. L. 96–223, title I, § 101(a)(1),
Apr. 2, 1980, 94 Stat. 241; amended Pub. L. 97–34, title VI,
§§ 601(b)(2), 603(b), 604(a)–(c), Aug. 13, 1981, 95 Stat.
337–339; Pub. L. 97–248, title II, § 291, Sept. 3, 1982, 96
Stat. 572; Pub. L. 97–448, title I, § 106(a)(2), (4)(B), (b),
title II, § 201(f), Jan. 12, 1983, 96 Stat. 2388, 2390, 2392, re-
lated to definitions and special rules with respect to ex-
empt oil.
Section 4995, added Pub. L. 96–223, title I, § 101(a)(1),
Apr. 2, 1980, 94 Stat. 244; amended Pub. L. 97–34, title VI,
§ 601(b)(3), Aug. 13, 1981, 95 Stat. 337; Pub. L. 97–448, title
II, § 201(g), Jan. 12, 1983, 96 Stat. 2393, related to with-
holding and depository requirements bearing on the
windfall profit tax.
Section 4996, added Pub. L. 96–223, title I, § 101(a)(1),
Apr. 2, 1980, 94 Stat. 247; amended Pub. L. 97–248, title
II, § 284(a), Sept. 3, 1982, 96 Stat. 569; Pub. L. 97–354,
§ 3(b)(1), Oct. 19, 1982, 96 Stat. 1688; Pub. L. 97–448, title
II, § 201(h)(1)(A)–(C), (2), Jan. 12, 1983, 96 Stat. 2393–2395,
provided for other definitions and special rules bearing
on the windfall profit tax.
Section 4997, added Pub. L. 96–223, title I, § 101(a)(1),
Apr. 2, 1980, 94 Stat. 249; amended Pub. L. 97–448, title
II, § 201(i)(1), Jan. 12, 1983, 96 Stat. 2395, related to
records and information, and regulations, bearing on
the windfall profit.
Section 4998, added Pub. L. 96–223, title I, § 101(a)(1),
Apr. 2, 1980, 94 Stat. 250, related to cross references.
AMENDMENTS
2017—Subsec. (a)(1). Pub. L. 115–97 substituted ‘‘sec-
tion 1(h)(1)(D)’’ for ‘‘section 1(h)(1)(C)’’.
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE OF 2017 AMENDMENT
Pub. L. 115–97, title I, § 13604(b), D
Source: Supplied 2024 U.S. Code historical extraction · 26 U.S.C. § 5000
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