This notice provides relief for certain health plans with non-calendar
year renewal dates that otherwise qualify as high-deductible health plans
(HDHPs), except that the plans provide state-mandated benefits without regard
to a deductible or with a deductible below the minimum annual deductible specified
in § 223(c)(2) of the Internal Revenue Code.
BACKGROUND AND APPLICATION
Some states require that health plans provide certain benefits without
regard to a deductible or with a deductible below the minimum annual deductible
specified in § 223(c)(2) (e.g., first-dollar
coverage or coverage with a low deductible). These health plans are not HDHPs
under § 223(c)(2) and individuals covered under these health plans
are generally not eligible to contribute to Health Savings Accounts (HSAs).
Notice 2004-43, 2004-2 C.B. 10, provides transition relief that treats health
plans as meeting the requirement of § 223(c)(2) when the sole reason
the plans are not HDHPs is because of certain state-mandated benefits. For
months before January 1, 2006, otherwise eligible individuals covered under
these health plans will be treated as eligible individuals for purposes of
§ 223(c)(1) and may contribute to an HSA. The transition period
provided in Notice 2004-43 covers months before January 1, 2006, for state-mandated
requirements in effect on January 1, 2004.
Generally, a health plan may not reduce existing benefits before the
plan’s renewal date. Thus, even though a state may amend its laws before
January 1, 2006, to authorize HDHPs that comply with § 223(c)(2),
non-calendar year plans may still fail to qualify as HDHPs after January 1,
2006, because existing benefits cannot be changed until the next renewal date.
For example, a state amends its laws to authorize HDHPs, effective November
1, 2005. A health plan with a renewal date of July 1, 2005, is required to
retain the state-mandated low-deductible coverage for the plan year July 1,
2005, through June 30, 2006, because the benefits can only be modified on
the renewal date. As a result, although the state has amended its statute,
the health plan will fail to be an HDHP for months after January 1, 2006 (i.e.,
for the months of January through June, 2006).
Therefore, additional transitional relief is appropriate for non-calendar
year health plans. Accordingly, the transition relief in Notice 2004-43 is
amplified to provide that for any coverage period of twelve months or less
beginning before January 1, 2006, a health plan that otherwise qualifies as
an HDHP as defined in § 223(c)(2), except that it complied on its
most recent renewal date before January 1, 2006, with state-mandated requirements
(in effect on January 1, 2004) to provide certain benefits without regard
to a deductible or with a deductible below the minimum annual deductible specified
in § 223(c)(2), will be treated as an HDHP. In no event will the
additional transitional relief provided in this notice extend beyond the earlier
of the health plan’s next renewal date or December 31, 2006.
EFFECT ON OTHER DOCUMENTS
Notice 2004-43, 2004-2 C.B. 10, is amplified.
The principal author of this notice is Elizabeth Purcell of the Office
of Division Counsel/Associate Chief Counsel (Tax Exempt and Government Entities).
For further information regarding this notice, contact Ms. Purcell at (202)
622-6080 (not a toll-free call).
You can either: Search all IRS Bulletin Documents issued since January 1996, or Search the entire site. For a more focused search, put your search word(s) in quotes.