Blue Cross & Blue Shield United of Wisconsin & Subsidiaries v. United States

56 Fed. Cl. 697, 91 A.F.T.R.2d (RIA) 2683, 2003 U.S. Claims LEXIS 146, 2003 WL 21488182
United States Court of Federal Claims·Decided June 12, 2003·No. No. 98-727T·Published·Cited by 2 cases

Opinion

OPINION

HORN, Judge.

This tax case was brought by Blue Cross & Blue Shield United of Wisconsin (BCW), the common parent company of a group of affiliated taxable insurance and service corpora[698] tions during the period at issue in this case.1 The present cross-motions for partial summary judgment2 concern the calculation of BCW’s Internal Revenue Code (IRC) section 832(c)(4) losses incurred deduction for tax year 1987. See 26 U.S.C. § 832(c)(4) (1982 & Supp. V 1987) (hereinafter IRC § 832(c)(4)). As delineated in IRC § 832(b)(5), in order to calculate its IRC § 832(c)(4) losses incurred deduction, BCW must determine the amount of its “unpaid losses,” or the “loss reserve.” Loss reserves are defined as “estimates of amounts insurers will have to pay for losses that have been reported but not yet paid, for losses that have been incurred but not yet reported, and for administrative costs of resolving claims.” Atl. Mut. Ins. Co. v. Comm'r, 523 U.S. 382, 384, 118 S.Ct. 1413, 140 L.Ed.2d 542 (1998). The issue in dispute is the method to be employed to determine the loss reserve for unpaid claims3 as of December 31, 1986. The plaintiff, BCW, contends that it is required to compute “its opening 1987 loss reserve for unpaid claims”4 using what is known as “actual claims paid” data for 1987; that is, “the actual amounts paid out during 1987 in satisfaction of [BCW’s] unpaid claims as of January 1,1987.” The defendant, however, maintains that the loss reserve for unpaid claims as of December 31,1986 should be computed using the actuarial estimate of BCW’s unpaid loss reserve, as reported on the company’s annual statement.5

The plaintiff makes two legal arguments. First, the plaintiff contends that the use of actual claims paid data to compute the loss reserve for unpaid claims is mandated by statute. Second, in the alternative, the plaintiff maintains that, even if the applicable statutes are “unclear or ambiguous,” any such ambiguity was resolved by the “Closing Agreement on Final Determination Covering Specific Matters” (Closing Agreement) between the plaintiff and the IRS, which states that BCW’s “January 1,1987 loss reserve for incurred-but-not-paid claims” should be determined “in accordance with actual claims paid data for 1987.”

In response, the defendant argues that BCW is required by statute to employ the actuarial estimate of its unpaid loss reserve as of December 31, 1986, as reported by BCW on its annual statement. The defendant also contends that the disputed provision in the Closing Agreement is not relevant to BCW’s IRC § 832(c)(4) deduction for tax year 1987. Finally, the defendant argues that the IRS did not agree to any matter pertaining to BCWs IRC § 832(c)(4) deduction for tax year 1987 in the Closing Agreement.

FINDINGS OF FACT

On May 15, 1986, the plaintiff filed Form 990, “Return of Organization Exempt from [699] Federal Income Tax,” with the IRS for the year ending December 31, 1985 (tax year 1985). On this return, the plaintiff stated that it was filing as an organization exempt from federal income tax pursuant to IRC § 501(c)(4).

On September 15, 1987, the plaintiff filed with the IRS two “U.S. Corporation Income Tax Returns” (Forms 1120), one for its tax year 1985 and a consolidated tax return6 for its tax year 1986. The Form 1120 for tax year 1985 was intended to replace the Form 990 previously filed for 1985. In an attachment to the newly filed 1985 Form 1120, the plaintiff explained that it filed the new Form 1120 returns for tax years 1985 and 1986 on September 15, 1987, because, according to BCW, “the aggregate, incremental changes in its operations that had occurred during the years prior to 1985 had been so material that, as of January 1, 1985, BCW no longer qualified for exemption under IRC § 501(c)(4).”

On the newly filed 1985 Form 1120, the plaintiff reported a net operating loss (NOL) of $36,887,982.00, which included a $5,450,687.00 NOL carryover from earlier years. The newly filed Form 1120 for tax year 1986 indicated a consolidated NOL for 1986 of $85,943,938.00, which was comprised of an $80,013,968.00 NOL for BCW, and $5,929,970.00 for the other related corporations. The $80,013,968.00 NOL claimed by BCW included the $36,887,982.00 NOL carried over from tax year 1985.

In 1988, the IRS District Director of the Milwaukee, Wisconsin District initiated audits that included a review of the income tax returns of BCW for tax years 1985 and 1986, as well as the returns of CHSIC, UWS, UWIC, UWLIC, LUI, and Proservices for those and other years. The IRS investigated whether BCW’s attempt to change its tax status to become a taxable entity for tax years 1985 and 1986 should be allowed. On September 27,1988, a request was submitted to the IRS Office of the Assistant Commissioner for technical advice on BCW’s tax status. On July 24,1991, that office issued a Technical Advice Memorandum, concluding that the plaintiff, as well as Blue Cross and Blue Shield organizations generally, was tax-exempt until January 1, 1987. In addition, the IRS Chief Counsel’s office issued a General Counsel Memorandum, concurring in this conclusion.

After concluding the audits of the Blue Cross entities, an examination report was issued on October 17,1991. In letters issued that same day, the IRS District Director of the Milwaukee District proposed certain adjustments to the tax returns of BCW, CHSIC, UWS, and UWIC, including the treatment of BCW as a tax-exempt organization until January 1, 1987, pursuant to IRC § 501(c)(4).

In December of 1991, some of BCW’s subsidiaries filed protests with the IRS, contesting certain findings in the October 17, 1991 letters. One of the disputed findings was the District Director’s claim that BCW was a tax-exempt entity in tax years 1985 and 1986; the subsidiaries argued that BCW was subject to federal income tax in those years. On January 6, 1992, the protests were assigned to the Milwaukee, Wisconsin Appeals Office for review. Ultimately, a settlement was reached, which included a Closing Agreement between BCW and the IRS. The agreement was executed on January 22, 1993, by C. Edward Mordy, Vice President of BCW, and on April 27, 1993, by Timothy I. Gukich, the IRS Associate Chief of Milwaukee Appeals, for the Commissioner of the IRS.

Free access — add to your briefcase to read the full text and ask questions with AI

Blue Cross & Blue Shield United of Wisconsin & Subsidiaries v. United States, 56 Fed. Cl. 697, 91 A.F.T.R.2d (RIA) 2683, 2003 U.S. Claims LEXIS 146, 2003 WL 21488182 (uscfc 2003).

56 Fed. Cl. 697 (Blue Cross & Blue Shield United of Wisconsin & Subsidiaries v. United States) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related