Employer Sponsored Accident And Health Insurance Benefits

October 28, 2024

8798 / What nondiscrimination requirements apply to self-insured health plans?

<div class="Section1">The nondiscrimination requirements set forth in IRC Section 105(h) apply to self-insured health benefits, although the IRS announced in Notice 2011-1 on December 22, 2010, that compliance with nondiscrimination rules for other health insurance plans will be delayed until regulations or other administrative guidance has been issued. The IRS indicated that the guidance will not apply until plan years beginning in a specified period after guidance is issued.<div class="Section1"> Benefits received pursuant to a self-insured plan are generally excludable from an employee’s gross income. Despite this, if a self-insured medical expense reimbursement plan or the self-insured part of a partly-insured medical expense reimbursement plan discriminates in favor of highly compensated individuals, certain amounts paid to the highly compensated individuals will be taxable to those highly compensated individuals. A medical expense reimbursement plan cannot be implemented retroactively because, if this were permitted, the nondiscrimination requirements of IRC Section 105 would be ineffective.<a href="#_ftn1" name="_ftnref1">1</a> A self-insured plan may not discriminate in favor of highly compensated individuals either with respect to eligibility to participate or benefits. Eligibility A plan discriminates as to eligibility to participate unless the plan benefits: <blockquote>(1)  70 percent or more of all employees, or 80 percent or more of all the employees who are eligible to benefit under the plan if 70 percent or more of all employees are eligible to benefit under the plan; or (2)  employees who qualify under a classification set up by the employer and found by the IRS not to be discriminatory in favor of highly compensated individuals.<a href="#_ftn2" name="_ftnref2">2</a></blockquote> For purposes of these eligibility requirements, an employer is not required to consider those employees who: <blockquote>(1)  have not completed three years of service at the beginning of the plan year; however, years of service during which an individual was ineligible under (2), (3), (4), or (5) below must be counted for this purpose; (2)  have not attained age 25 at the beginning of the plan year; (3)  are part-time or seasonal employees; (4)  are covered by a collective bargaining agreement if health benefits were the subject of good faith bargaining; or (5)  are nonresident aliens with no U.S.-source earned income.<a href="#_ftn3" name="_ftnref3">3</a></blockquote> Part-time and Seasonal Workers Part-time employees include those employees who are customarily employed for fewer than 35 hours per week. Seasonal employees are those who are customarily employed for fewer than nine months per year. In determining whether an employee is part-time or seasonal, the IRS will consider whether similarly situated employees of the employer (or employees in the same industry or location as the employer) are employed for substantially more hours or months, as applicable. A safe harbor rule provides that employees customarily employed for fewer than 25 hours per week or seven months per year may automatically be considered part-time or seasonal.<a href="#_ftn4" name="_ftnref4">4</a> Benefits A plan discriminates as to benefits unless all benefits provided for participants who are highly compensated individuals are provided for all other participants.<a href="#_ftn5" name="_ftnref5">5</a> If some participants become eligible for benefits immediately and others only after a waiting period, benefits are not considered to be available to all participants.<a href="#_ftn6" name="_ftnref6">6</a> Benefits available to dependents of highly compensated employees must be equally available to dependents of all other participating employees. The test is applied to benefits subject to reimbursement, rather than to actual benefit payments or claims. Any maximum limit on the amount of reimbursement must be uniform for all participants and for all dependents, regardless of years of service or age. Further, if the type or amount of benefits subject to reimbursement is offered in proportion to compensation and highly compensated employees are covered by the plan, the plan will be found to discriminate with regard to benefits. A plan will not be considered discriminatory in operation merely because highly compensated participants use a broad range of plan benefits to a greater extent than other participants.<a href="#_ftn7" name="_ftnref7">7</a> The nondiscrimination rules are not violated merely because benefits under the plan are offset by benefits paid under a self-insured or insured plan of the employer, of another employer, or by benefits paid under Medicare or other federal or state law. A self-insured plan may take into account benefits provided under another plan only to the extent that the benefit is the same under both plans.<a href="#_ftn8" name="_ftnref8">8</a> Benefits provided to a retired employee who was highly compensated must be the same as benefits provided to all other retired participants. For purposes of applying the nondiscrimination rules, all employees of a controlled group of corporations, or employers under common control, and of members of an affiliated service group are treated as employed by a single employer.<a href="#_ftn9" name="_ftnref9">9</a> Highly Compensated Individual An employee is a highly compensated individual if the employee falls into any one of the following three classifications: <blockquote>(1)  The employee is one of the five highest paid officers. (2)  The employee is a shareholder who owns, either actually or constructively through application of the attribution rules, more than 10 percent in value of the employer’s stock. (3)  The employee is among the highest paid 25 percent, rounded to the nearest higher whole number, of all employees other than excludable employees who are not participants and not including retired participants.<a href="#_ftn10" name="_ftnref10">10</a> Fiscal year plans may determine compensation on the basis of the calendar year ending in the plan year.</blockquote> A participant’s status as officer or stockholder with respect to a particular benefit is determined at the time when the benefit is provided.<a href="#_ftn11" name="_ftnref11">11</a> See Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8799">8799</a> for a discussion of the tax consequences to a self-insured plan that is found to be discriminatory under these rules. </div><div class="refs"> <hr align="left" size="1" width="33%"> <a href="#_ftnref1" name="_ftn1">1</a>.  Wollenburg v. U.S., 75 F. Supp. 2d 1032, 1035 n.2 (D. Neb. 1999) (noting that “an employer can choose to benefit or hurt certain employees with much greater precision, with the benefit of hindsight.”); American Family Mut. Ins. Co. v. U.S., 815 F. Supp. 1206 (W.D. Wis. 1992). See also Rev. Rul. 2002-58, 2002-38 IRB 541. <a href="#_ftnref2" name="_ftn2">2</a>.  IRC § 105(h)(3)(A). <a href="#_ftnref3" name="_ftn3">3</a>.  IRC § 105(h)(3)(B). <a href="#_ftnref4" name="_ftn4">4</a>.  Treas. Reg. § 1.105-11(c). <a href="#_ftnref5" name="_ftn5">5</a>.  IRC § 105(h)(4). <a href="#_ftnref6" name="_ftn6">6</a>.  Let. Ruls. 8411050, 8336065. <a href="#_ftnref7" name="_ftn7">7</a>.  Treas. Reg. § 1.105-11(c)(3). <a href="#_ftnref8" name="_ftn8">8</a>.  Treas. Reg. § 1.105-11(c)(1). <a href="#_ftnref9" name="_ftn9">9</a>.  IRC § 105(h). <a href="#_ftnref10" name="_ftn10">10</a>.  IRC § 105(h)(5). <a href="#_ftnref11" name="_ftn11">11</a>.  Treas. Reg. § 1.105-11(d). </div></div>

October 28, 2024

8789 / Is the value of employer-provided coverage under accident or health insurance taxable income to an employee?

<div class="Section1">Generally, no. This includes medical expense and dismemberment and sight loss coverage for the employee, the employee’s spouse and dependents, and coverage providing for disability income for the employee. Unlike the exclusion for group-term life insurance, there is no specific limit on the amount of employer-provided accident or health coverage that may be excluded from an employee’s gross income. Further, coverage is tax-exempt to an employee when it is provided under a group insurance policy.<a href="#_ftn1" name="_ftnref1">1</a> Similarly, the employee is not taxed on the value of critical illness coverage.<div class="Section1"> Accidental death coverage apparently also is excludable from an employee’s gross income under IRC Section 106(a).<a href="#_ftn2" name="_ftnref2">2</a> The IRS has ruled privately that the value of consumer medical cards purchased by a partnership for its employees was excludable from the employees’ income under IRC Section 106(a).<a href="#_ftn3" name="_ftnref3">3</a> Where an employer applies salary reduction amounts to the payment of health insurance premiums for employees, the salary reduction amounts are excludable from gross income under IRC Section 106.<a href="#_ftn4" name="_ftnref4">4</a> On the other hand, an employee must include in income payments received from an employer that may be used to pay the accident and health insurance premiums if those amounts are not required to be used for that purpose.<a href="#_ftn5" name="_ftnref5">5</a> Employers are generally no longer permitted to reimburse employees for the cost of premiums for individual insurance policies purchased by the employee without incurring a penalty. Beginning in 2017, certain small employers may use a qualified small employer health reimbursement arrangement (QSEHRA) to reimburse employees for the cost of health coverage without incurring a penalty (see Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8808">8808</a>). Beginning in 2020, individual coverage HRAs (ICHRAs) may be used to reimburse employees for the cost of individual health insurance without incurring a penalty. See Q <a href="javascript:void(0)" class="accordion-cross-reference" id=""></a> to Q <a href="javascript:void(0)" class="accordion-cross-reference" id=""></a> for details. Where a taxpayer’s contribution to a fund providing retiree health benefits is deducted from the taxpayer’s after-tax salary, it is considered an employee contribution and is includable in the taxpayer’s income under IRC Section 61. In contrast, where an employer increases or grosses up a taxpayer’s salary and then deducts the fund contribution from the taxpayer’s after-tax salary, the contribution is considered to be an employer contribution that is excludable from the gross income of the taxpayer under IRC Section 106.<a href="#_ftn6" name="_ftnref6">6</a> The IRS has ruled privately that a return of a premium rider on a health insurance policy was a benefit in addition to accident and health benefits, so that the premium paid by the employer had to be included in the employee’s taxable income.<a href="#_ftn7" name="_ftnref7">7</a> For purposes of determining the tax treatment of employer-provided accident and health insurance, full time life insurance salespersons are treated as employees if they are employees for Social Security purposes.<a href="#_ftn8" name="_ftnref8">8</a> Coverage for other commission salespersons is taxable income to the salespersons, unless an employer-employee relationship exists.<a href="#_ftn9" name="_ftnref9">9</a> Discrimination generally does not affect exclusion of the value of coverage. Even if a self-insured medical expense reimbursement plan discriminates in favor of highly compensated employees, the value of coverage is not taxable; only reimbursements are affected. For a discussion of the considerations applicable to S corporations, see Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8966">8966</a> to Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8976">8976</a>. </div><div class="refs"> <hr align="left" size="1" width="33%"> <a href="#_ftnref1" name="_ftn1">1</a>.  IRC § 106(a). See also Treas. Reg. § 1.106-1; Rev. Rul. 58-90, 1958-1 CB 88; Rev. Rul. 56-632, 1956-1 CB 101. <a href="#_ftnref2" name="_ftn2">2</a>.  Treas. Reg. § 1.106-1; Treas. Reg. § 1.79-1(f)(3); Let. Ruls. 8801015, 8922048. <a href="#_ftnref3" name="_ftn3">3</a>.  Let. Rul. 9814023. <a href="#_ftnref4" name="_ftn4">4</a>.  Rev. Rul. 2002-03, 2002-1 CB 316. <a href="#_ftnref5" name="_ftn5">5</a>.  Rev. Rul. 75-241, 975-1 CB 316, Let. Rul. 9022060. See also Let. Rul. 9104050. <a href="#_ftnref6" name="_ftn6">6</a>.  Let. Rul. 9625012. <a href="#_ftnref7" name="_ftn7">7</a>.  Let. Rul. 8804010. <a href="#_ftnref8" name="_ftn8">8</a>.  IRC § 7701(a)(20). <a href="#_ftnref9" name="_ftn9">9</a>.  Rev. Rul. 56-400, 1956-2 CB 116; see also IRC § 3508. </div></div>

October 28, 2024

8799 / What are the tax consequences for amounts paid by an employer to highly compensated employees under a discriminatory self-insured medical expense reimbursement plan?

<div class="Section1">If a self-insured medical reimbursement plan is found to be discriminatory in favor of highly compensated employees, those highly compensated employees may be taxed on reimbursed amounts provided under the plan. The taxable amount of payments is the “excess reimbursement.”<a href="#_ftn1" name="_ftnref1">1</a> The two situations discussed below will produce an excess reimbursement.</div> <div class="Section1"> The first situation occurs when a benefit is available to a highly compensated individual but not to all other participants, or if the benefit otherwise discriminates in favor of highly compensated individuals. In this case, the total amount reimbursed under the plan to the employee with respect to that benefit is an excess reimbursement. The second situation occurs when a plan discriminates as to participation, even though all benefits are available to all other participants and are not otherwise discriminatory. If this is the case, the excess reimbursement is determined by multiplying the total amount reimbursed to the highly compensated individual for the plan year by a fraction. The numerator of this fraction is the total amount reimbursed to all participants who are highly compensated individuals under the plan for the plan year and the denominator is the total amount reimbursed to all employees under the plan for such plan year. In determining the fraction, any reimbursement attributable to a benefit not available to all other participants is not taken into account.<a href="#_ftn2" name="_ftnref2">2</a> Multiple plans may be designated as a single plan for purposes of satisfying nondiscrimination requirements. If an employee elects to participate in an optional HMO offered by the plan, that employee is considered benefited by the plan only if the employer’s contributions with respect to the employee are at least equal to what would have been made to the self-insured plan and the HMO is designated, with the self-insured plan, as a single plan. Unless a plan provides otherwise, reimbursements will be attributed to the plan year in which payment is made. Accordingly, they will be subject to tax in an individual’s tax year in which a plan year ends. Amounts reimbursed for medical diagnostic procedures for employees, but not dependents, performed at a facility that provides only medical services are not considered a part of a plan and do not come within these rules requiring nondiscriminatory treatment.<a href="#_ftn3" name="_ftnref3">3</a> </div> <div class="refs"> <hr align="left" size="1" width="33%" /> <a href="#_ftnref1" name="_ftn1">1</a>. IRC § 105(h)(1). <a href="#_ftnref2" name="_ftn2">2</a>. IRC § 105(h)(7). <a href="#_ftnref3" name="_ftn3">3</a>. Treas. Reg. § 1.105-11(g). </div>

March 13, 2024

8791 / Is the value of employer-provided coverage under accident or health insurance taxable income to an employee when the coverage is provided for the employee’s spouse, children or dependents?

<div class="Section1">Employer-provided accident and health coverage for an employee and the employee’s spouse and dependents, both before and after retirement, and for the employee’s surviving spouse and dependents after the employee’s death, does not have to be included in gross income by the active or retired employee or, after the employee’s death, by the employee’s survivors.<a href="#_ftn1" name="_ftnref1">1</a></div> <div class="Section1"> In 2010, the Affordable Care Act (“ACA”), expanded the exclusion from gross income for amounts expended on medical care to include employer-provided health coverage for any adult child of the taxpayer if the adult child has not attained the age of 27 as of the end of the taxable year. The IRS has released guidance indicating that the exclusion applies regardless of whether the adult child is eligible to be claimed as a dependent for tax purposes.<a href="#_ftn2" name="_ftnref2">2</a> </div> <div class="refs"> <hr align="left" size="1" width="33%" /> <a href="#_ftnref1" name="_ftn1">1</a>. Rev. Rul. 82-196, 1982-2 CB 53; GCM 38917 (11-17-82). <a href="#_ftnref2" name="_ftn2">2</a>. IRC § 105(b), as amended by the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010. Notice 2010-38, 2010-20 IRB 682. </div>

March 13, 2024

8793 / Are benefits paid under an employer-sponsored plan by reason of the employee’s death received tax-free?

<div class="Section1">Accidental death benefits under an employer’s plan are received income tax-free by an employee’s beneficiary under IRC Section 101(a) as life insurance proceeds payable by reason of the insured’s death.<a href="#_ftn1" name="_ftnref1">1</a> Death benefits payable under life insurance contracts issued after December 31, 1984, are excludable if the contract meets the statutory definition of a life insurance contract in IRC Section 7702. See Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8763">8763</a> to Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8785">8785</a> for a detailed discussion of the tax treatment of life insurance death proceeds. Survivors’ Benefits Benefits paid to a surviving spouse and dependents under an employer accident and health plan that provided coverage for an employee and the employee’s spouse and dependents both before and after retirement, and to the employee’s surviving spouse and dependents after the employee’s death, are excludable to the extent that they would be if paid to the employee.<a href="#_ftn2" name="_ftnref2">2</a> <div class="refs"> <hr align="left" size="1" width="33%"> <a href="#_ftnref1" name="_ftn1">1</a>.  Treas. Reg. § 1.101-1(a). <a href="#_ftnref2" name="_ftn2">2</a>.  Rev. Rul. 82-196, 1982-2 CB 53; GCM 38917 (11-17-82). </div></div>

March 13, 2024

8806 / What ordering rules for reimbursement apply if a taxpayer maintains both an HRA and a health FSA?

<div class="Section1">An employee may not be reimbursed for the same medical care expense by both an HRA and an IRC Section 125 health FSA (see Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8834">8834</a>). Technically, ordering rules from the IRS specify that the HRA benefits must be exhausted before FSA reimbursements may be made. Despite this, HRAs can be drafted to specify that coverage under the HRA is available only after expenses exceeding the dollar amount of an IRC Section 125 FSA have been paid. Thus, an employee could exhaust FSA coverage, because FSA funds may only be carried over if the FSA specifically permits a carryover (and even then only up to $500 per year ($660 in 2025 projected, $640 in 2024, $610 in 2023, $570 in 2022 and $550 in 2020 and 2021)<a href="#_ftn1" name="_ftnref1">1</a> can be carried forward), before tapping into HRA coverage, which can be carried over.<a href="#_ftn2" name="_ftnref2">2</a><div class="refs"> <hr align="left" size="1" width="33%"> <a href="#_ftnref1" name="_ftn1">1</a>.  Notice 2020-23. <a href="#_ftnref2" name="_ftn2">2</a>.  Notice 2002-45, 2002-2 CB 93. </div></div>

March 13, 2024

8790 / Is the value of employer-provided coverage under accident or health insurance taxable income to an employee if the employee has a choice as to whether to receive coverage or a higher salary?

<div class="Section1">Outside of the context of cafeteria plans, if an employer offers an employee a choice between a lower salary and employer-paid health insurance or a higher salary and no health insurance, the employee must include the full amount of the higher salary in income regardless of the employee’s choice. If the employee selects the health insurance option, the IRS will deem the employee to have received the higher salary and, in turn, paid a portion of the salary equal to the health insurance premium to the insurance company.<a href="#_ftn1" name="_ftnref1">1</a></div> <div class="Section1"> However, a federal district court faced with a similar fact situation ruled that for employees who accept employer-paid health insurance coverage, the difference between the higher salary and the lower one is not subject to FICA and FUTA taxes or to income tax withholding.<a href="#_ftn2" name="_ftnref2">2</a> </div> <div class="refs"> <hr align="left" size="1" width="33%" /> <a href="#_ftnref1" name="_ftn1">1</a>. Let. Rul. 9406002. See also Let. Rul. 9513027. <a href="#_ftnref2" name="_ftn2">2</a>. Express Oil Change, Inc. v. U.S., 25 F. Supp. 2d 1313 (N.D. Ala. 1996), aff’d, 162 F.3d 1290 (11th Cir. 1998). </div>

March 13, 2024

8797 / Are reimbursements attributable to employee contributions to a self-insured health plan taxable to the employee?

<div class="Section1">Generally, reimbursements attributable to employee contributions are received tax-free. However, an employee must include any reimbursed amount to the extent that the employee has taken a deduction for the expense.</div> <div class="Section1"> Amounts attributable to employer contributions are determined based on the ratio that employer contributions bear to total contributions for the calendar years immediately preceding the year of receipt (up to three years may be taken into account). If the plan has been in effect for less than a year, then the determination may be based upon the portion of the year, or such determination may be made periodically (such as monthly or quarterly) and used throughout the succeeding period.<a href="#_ftn1" name="_ftnref1">1</a> For example, if an employee leaves employment on April 15, 2024, and 2024 is the first year the plan was in effect, the determination may be based upon the contributions of the employer and the employees during the period beginning with January 1 and ending with April 15, or during the month of March, or during the quarter consisting of January, February, and March. </div> <div class="refs"> <hr align="left" size="1" width="33%" /> <a href="#_ftnref1" name="_ftn1">1</a>. Treas. Reg. § 1.105-11(i). </div>

March 13, 2024

8807 / Can HRA contributions be made via salary reduction or through a cafeteria plan?

<div class="Section1">Employer contributions to an HRA may not be attributable in any way to salary reductions. Thus, an HRA may not be offered under a cafeteria plan, but may be offered in connection with a cafeteria plan. Where an HRA is offered in connection with another accident or health plan funded by a salary reduction plan, a facts and circumstances test is used to determine if salary reductions are attributable to the HRA. If a salary reduction amount for a coverage period to fund a non-HRA accident or health plan exceeds the actual cost of the non-specified accident or health plan coverage, the salary reduction will be attributed to the HRA. An example of the application of this rule can be found in Revenue Ruling 2002-41.<a href="#_ftn1" name="_ftnref1">1</a></div> <div class="Section1"> Because an HRA may not be paid for through salary reduction, the following restrictions on health FSAs are not applicable to HRAs: <blockquote>(1) The ban against a benefit that defers compensation by permitting employees to carry over an unlimited amount of unused elective contributions or plan benefits from one plan year to another plan year. (2) The requirement that the maximum amount of reimbursement must be available at all times during the coverage period. (3) The mandatory 12-month period of coverage. (4) The limitation that reimbursed medical expenses must be incurred during the period of coverage.<a href="#_ftn2" name="_ftnref2">2</a></blockquote> </div> <div class="refs"> <hr align="left" size="1" width="33%" /> <a href="#_ftnref1" name="_ftn1">1</a>. 2002-2 CB 75. <a href="#_ftnref2" name="_ftn2">2</a>. Notice 2002-45, 2002-2 CB 93. </div>

March 13, 2024

8788 / What credit is available for small employers who contribute to employee health insurance costs?

<div class="Section1">Eligible small employers may take advantage of a tax credit for employee health insurance expenses for taxable years beginning after December 31, 2009, provided the employer offers health insurance to its employees and makes a non-elective contribution on behalf of each employee who participates in the plan.<a href="#_ftn1" name="_ftnref1">1</a><div class="Section1"> An eligible small employer is defined as an employer that has no more than 25 full time employees, the average annual wages of whom do not exceed $64,800 (in 2024, $61,400 in 2023, $57,400 for 2022, $55,600 for 2021 and $55,200 for 2020).<a href="#_ftn2" name="_ftnref2">2</a> In order to qualify, the employer must have a contribution arrangement for each employee who enrolls in the health plan offered by the employer through an exchange that requires that the employer make a non-elective contribution in an amount equal to a uniform percentage, not less than 50 percent, of the premium cost.<a href="#_ftn3" name="_ftnref3">3</a> Subject to phase-out<a href="#_ftn4" name="_ftnref4">4</a> based on the number of employees and average wages, the amount of the credit is equal to 50 percent, and 35 percent in the case of tax-exempt organizations, of the lesser of: <blockquote>(1)  the aggregate amount of non-elective contributions made by the employer on behalf of its employees for health insurance premiums for health plans offered by the employer to employees through an exchange; or (2)  the aggregate amount of non-elective contributions the employer would have made if each employee had been enrolled in a health plan that had a premium equal to the average premium for the small group market in the ratings area.<a href="#_ftn5" name="_ftnref5">5</a></blockquote> For years 2010 through 2013, the following modifications apply in determining the amount of the credit: <blockquote>(1)  The credit percentage is reduced to 35 percent (25 percent in the case of tax-exempt entities).<a href="#_ftn6" name="_ftnref6">6</a> (2)  The amount under (1) is determined by reference to non-elective contributions for premiums paid for health insurance, and there is no exchange requirement.<a href="#_ftn7" name="_ftnref7">7</a> (3)  The amount under (2) is determined by the average premium for the state small group market.<a href="#_ftn8" name="_ftnref8">8</a></blockquote> The credit also is allowed against the alternative minimum tax.<a href="#_ftn9" name="_ftnref9">9</a> <hr> Planning Point: Proposed regulations explain how to calculate employer tax credits after 2013.<a href="#_ftn10" name="_ftnref10">10</a> The regulations propose that the maximum credit for taxable years after 2014 (available for only two years) increase to 50 percent (35 percent for tax-exempt organizations), with some adjustments. There is a proposed phase out for small employers with more than 10 employees or whose average annual wages exceed $25,000 (adjusted for inflation). In addition, the proposed regulations clarify that employer contributions to an HRA, FSA, or HSA are not considered premium payments<a href="#_ftn11" name="_ftnref11">11</a> (see Q <a href="javascript:void(0)" class="accordion-cross-reference" id="8840">8840</a>). <hr> </div><div class="refs"> <hr align="left" size="1" width="33%"> <a href="#_ftnref1" name="_ftn1">1</a>.  IRC § 45R, as added by PPACA 2010. <a href="#_ftnref2" name="_ftn2">2</a>.  IRC § 45R(d), as added by PPACA 2010; IRC § 45R(d)(3)(B), as amended by Section 10105(e)(1) of PPACA 2010. <a href="#_ftnref3" name="_ftn3">3</a>.  IRC § 45R(d)(4), as added by PPACA 2010. <a href="#_ftnref4" name="_ftn4">4</a>.  IRC § 45R(c), as added by PPACA 2010. <a href="#_ftnref5" name="_ftn5">5</a>.  IRC § 45R(b), as added by PPACA 2010. <a href="#_ftnref6" name="_ftn6">6</a>.  IRC § 45R(g)(2)(A), as added by PPACA 2010. <a href="#_ftnref7" name="_ftn7">7</a>.  IRC §§ 45R(g)(2)(B), 45R(g)(3), as added by PPACA 2010. <a href="#_ftnref8" name="_ftn8">8</a>.  IRC § 45R(g)(2)(C), as added by PPACA 2010. <a href="#_ftnref9" name="_ftn9">9</a>.  IRC § 38(c)(4)(B), as amended by PPACA 2010. The IRS has issued guidance; see Notice 2010-44, 2010-22 IRB 717; Notice 2010-82, 2010-51 IRB 1. <a href="#_ftnref10" name="_ftn10">10</a>.  2013 IRB LEXIS, 2013-38 IRB 211 (modifying Notice 2010-44, 2010-22 IRB 717; Notice 2010-82, 2010-51 IRB 1). <a href="#_ftnref11" name="_ftn11">11</a>.  Prop. Treas. Reg. § 1.45R-3. </div></div>