Clarify terms for “covered entity” for health insurance provider fee

Regulations: Clarify terms for “covered entity”

The Treasury Department and IRS today released for publication in the Federal Register final and temporary regulations (T.D. 9711) and, by cross-reference proposed regulations (REG-143416-14) regulations that provide rules for the definition of a covered entity for purposes of the fee imposed by section 9010 of the Patient Protection and Affordable Care Act, as amended.

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In late November 2013, the Treasury Department and the IRS issued final regulations on the health insurance providers fee (T.D. 9643). In August 2014, the Treasury Department and the IRS issued Notice 2014-47 to provide further guidance for the 2014 fee year on the application of the controlled group rules to entities that are statutorily excluded from the definition of a covered entity.


Today's temporary [PDF 224 KB] and proposed [PDF 221 KB] regulations extend the guidance provided in Notice 2014-47 to the 2015 fee year and subsequent fee years. In addition, the regulations impose a consistency requirement that binds an entity to its original selection of either the data year or fee year to determine whether it qualifies for a statutory exclusion from the fee.

Before the proposed regulations are adopted as final regulations, the IRS is requesting comments on all aspects of the proposed regulations. Comments must be received by 90-days after the date of publication in the Federal Register, which is dated February 26, 2015.

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