Blue Cross & Blue Shield United v. United States

71 Fed. Cl. 641, 98 A.F.T.R.2d (RIA) 5001, 2006 U.S. Claims LEXIS 187, 2006 WL 1793670
CourtUnited States Court of Federal Claims
DecidedJune 29, 2006
DocketNo. 98-727T
StatusPublished
Cited by3 cases

This text of 71 Fed. Cl. 641 (Blue Cross & Blue Shield United v. United States) is published on Counsel Stack Legal Research, covering United States Court of Federal Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blue Cross & Blue Shield United v. United States, 71 Fed. Cl. 641, 98 A.F.T.R.2d (RIA) 5001, 2006 U.S. Claims LEXIS 187, 2006 WL 1793670 (uscfc 2006).

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 corporations during the period at issue in this case. In a previous opinion, this court granted partial summary judgment for the government. See Blue Cross & Blue Shield United of Wis. & Subsidiaries v. United States (Blue Cross I), 56 Fed.Cl. 697 (2003). Following that decision, the parties entered into a stipulation for partial dismissal and for entry of judgment of the remaining issues in the case, those not the subject of the court’s opinion. See Blue Cross & Blue Shield United of Wis. & Subsidiaries v. United States (Blue Cross II), No. 98-727T, 2003 WL 22327886 (Fed.Cl. Sept.3, 2003). On appeal from the court’s decision granting summary judgment for the defendant, the United States Court of Appeals for the Federal Circuit reversed in part and remanded the case in order for this court to consider extrinsic evidence. See Blue Cross & Blue Shield United of Wis. & Subsidiaries v. United States (Blue Cross III), 117 Fed.Appx. 89, 94 (2004).

FINDINGS OF FACT

The facts and background of this case were set forth in detail in the court’s previous opinion. See Blue Cross I, 56 Fed.Cl. at 698-702. For this reason, only a summary of the facts previously determined by this court are presented here. The facts detailed in the court’s earlier opinion are incorporated into this opinion. At issue is 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 stated 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 its “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 re[643]*643solving claims.” Atl. Mut. Ins. Co. v. Comm’r, 523 U.S. 382, 384, 118 S.Ct. 1413, 140 L.Ed.2d 542 (1998).

The dispute between the parties is the method to be employed to determine BCW’s loss reserve for unpaid claims as of December 31, 1986. The plaintiff, BCW, contends that it should compute “its opening 1987 loss reserve for unpaid claims” using its “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. See Blue Cross I, 56 Fed.Cl. at 698.

On May 15, 1986, the plaintiff filed with the IRS Form 990, “Return of Organization Exempt from Federal Income Tax,” 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 return1 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).” Blue Cross I, 56 Fed.Cl. at 698.

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 September, 1988, the IRS District Director of the Milwaukee, Wisconsin District submitted a Request for Technical Advice from the IRS Assistant Commissioner (Technical), in Washington, D.C. The principal question presented in the Request for Technical Advice was whether BCW could revoke its tax exempt status under IRC § 501(c)(4) on September 15, 1986, effective for tax years beginning after December 31, 1984. See Blue Cross I, 56 Fed.Cl. at 699. By a letter dated July 24, 1991, the IRS issued a Technical Advice Memorandum, concluding that BCW was tax-exempt under IRC § 501(e)(4) for tax years 1985 and 1986. Id. In addition, on July 28, 1991, the IRS Chief Counsel’s office issued a General Counsel Memorandum, concurring in the conclusion that Blue Cross organizations were tax exempt. Id.

To resolve the dispute between BCW and the IRS, 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. Gukieh, the IRS Associate Chief of Milwaukee Appeals, for the Commissioner of the IRS.

With respect to BCWs taxable status for tax years 1985 and 1986, the Closing Agreement stated that BCW would be considered tax-exempt during 1985 and 1986: “NOW IT IS HEREBY DETERMINED AND AGREED for Federal income tax purposes that: (1) Prior to 1987, the taxpayer was, per section 501, Subtitle A, IRC, an organization [644]*644exempt from taxation.” Despite the statement in the Closing Agreement that the plaintiff would be considered a tax-exempt entity for tax years 1985 and 1986, in the Closing Agreement, BCW was permitted a $25,000,000.00 NOL for tax years 1984, 1985, and 1986, which could be carried over to 1987 and later years.

Subparagraph (e) of paragraph 3 of the Closing Agreement is the portion of the Closing Agreement at issue in this case. That paragraph states:

(3) As of January 1, 1987, the taxpayer was an “Existing Blue Cross or Blue Shield organization” as this term is defined in subparagraph (e)(2) of section 833, Subtitle A, IRC. As such, the following attributes apply to the taxpayer as of that date: ... (e) the taxpayer’s January 1, 1987 loss reserve for incurred-but-not-paid claims will be determined in accordance with actual claims paid data for 1987[.]

On its original 1987 return, BCW claimed an IRC § 832(c)(4) deduction for “losses incurred” in the amount of $190,155,418.00. To arrive at that number, BCW determined its “discounted unpaid losses outstanding at the end of 1986” to be $85,352,778.00. According to BCW, it calculated this number by:

(a) starting with the estimate of the amount needed to satisfy total claims unpaid as of that date, as reported on its 1986 Annual Statement for 1986 ($78,421,-394.00);2

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71 Fed. Cl. 641, 98 A.F.T.R.2d (RIA) 5001, 2006 U.S. Claims LEXIS 187, 2006 WL 1793670, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blue-cross-blue-shield-united-v-united-states-uscfc-2006.