Capital Blue Cross and Subsidiaries v. Commissioner of Internal Revenue

431 F.3d 117, 96 A.F.T.R.2d (RIA) 7247, 2005 U.S. App. LEXIS 26474
CourtCourt of Appeals for the Third Circuit
DecidedDecember 5, 2005
Docket04-2645
StatusPublished
Cited by17 cases

This text of 431 F.3d 117 (Capital Blue Cross and Subsidiaries v. Commissioner of Internal Revenue) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Capital Blue Cross and Subsidiaries v. Commissioner of Internal Revenue, 431 F.3d 117, 96 A.F.T.R.2d (RIA) 7247, 2005 U.S. App. LEXIS 26474 (3d Cir. 2005).

Opinion

OPINION OF THE COURT

BECKER, Circuit Judge.

I.Introduction...............................................................119

II.Facts and Procedural History................................................120

A. Introduction...........................................................120

B. Initial Taxation of Blue Cross Blue Shield Entities..........................120

C. Capital’s Contracts in 1987 ..............................................121

1. Premium structures..................1..............................121

2. Renewals..........................................................122

3. Valuation..........................................................122

D. The Present Controversy................................................122

III.Deductibility of Losses on Health Insurance Contracts..........................124

A. The Blue Cross Blue Shield Fresh Start Basis Rule.........................124

B. Deductibility of Non-Sale Losses by Blue Cross Blue Shield Organizations........................................................125

C. Are the Insurance Contracts Mass Assets?................................125

IV.Burden of Proof of Deduction Amounts .......................................128

A. Who Bears the Burden of Proof?.........................................128
B. Proof of Separate Valuation ..............................................129

V.Capital’s Valuation....................... 131

A. The Reinsurance Model............... 131

1. Highest and best use.............. 131

2. Separate values .................. 132

3. The goodwill adjustment........... 133

B. Specific Contract Characteristics....... 134
C. Lapse Rates and “Lifíng Analysis”..... 136

1. Prospective changes in the market.. 137

2. Human factors................... 139

3. The Commissioner’s lifing arguments 139
D. The Commissioner’s Objections........ 140
E. Summary and Conclusions............. 140
I. Introduction

Capital Blue Cross (“Capital”) appeals from a decision of the United States Tax Court denying its request for a refund of overpayment of taxes for tax year 1994. Capital claims that it properly established a basis in hundreds of insurance contracts that were terminated in that year, and that it is therefore entitled to take a loss deduction under 26 U.S.C. § 165 to account for the cancellation of those contracts. The Tax Court found that Capital had not established its basis in those contracts; it therefore treated Capital’s basis as zero and denied any deduction.

We agree with Capital that the Tax Court improperly discounted expert testimony that tended to establish Capital’s basis in the disputed contracts, and that the zero basis found by the Court was inconsistent with the facts and hence clearly erroneous. Capital engaged in an extensive and professional valuation process in order to calculate its basis in the lost contracts. While the Tax Court correctly found that the Commissioner of Internal Revenue (“the Commissioner”) established several flaws in Capital’s valuation, overall, we are convinced that Capital’s process was thorough and professional, and that it *120 arrived at an essentially reasonable valuation for the cancelled contracts. Given these conclusions, we are unwilling to affirm the Tax Court merely because we find some flaws in Capital’s valuation process. Instead, we will reverse and remand for further proceedings.

We leave it to the Tax Court to find the correct valuation for Capital’s contracts. On remand, the Commissioner may again press his objections to Capital’s methods, and the Tax Court may consider those objections in arriving at a final valuation. But the existence of some problems in Capital’s valuation process will not justify finding a zero basis in the lost contracts. Instead, the Tax Court must do its best to calculate a reasonable and correct basis; the Commissioner can best assist the Court by raising specific and quantifiable objections to Capital’s valuation, and by proposing alternative methods that will lead to what, in his submission, would be a more reasonable valuation. Thus far, the Commissioner has pointed to alleged flaws in the valuation methodology without explaining or quantifying how they impacted the bottom-line calculation, and without offering any alternatives. We conclude that, on the facts before us, such a procedure is insufficient to reject Capital’s claimed deductions.

II. Facts and Procedural History
A. Introduction

As suggested above, this case concerns the procedures under which Blue Cross Blue Shield organizations may take loss deductions for terminated subscriber contracts. Since Blue Cross Blue Shield organizations became taxable in 1986, this issue has slowly grown in importance. It has only recently reached the attention of the courts and the Internal Revenue Service (“IRS” or “the Service”). The Service has

inform[ed] Blue Cross Blue Shield insurance organizations that the Service will challenge deductions for losses that relate to the termination of individual customer, provider, or employee contracts or relationships associated with customer lists, provider networks, and workforce in place with respect to which the taxpayer claims an adjusted basis derived from section 1012(c)(3)(A)(iii) [sic] of the Tax Reform Act of 1986.

I.R.S. Notice 2000-34, 2000-2 C.B. 172.

We are the second Article III court to consider the deductibility of these losses. The first ease was Trigon Insurance Co. v. United States, 215 F.Supp.2d 687 (E.D.Va. 2002), which found for the Commissioner and disallowed the deductions. The court ultimately held that the taxpayer — Trigon, a success or to two Blue Cross Blue Shield insurers — had not established the 1987 fan-market value of its insurance and provider contracts and was therefore not entitled to a deduction. The decision has not been appealed, and our analysis will be guided in part by Judge Payne’s thorough opinion. Since Trigon, the IRS has reaffirmed and clarified the position of Notice 2000-34 in a Coordinated Issue Paper dated May 27, 2005. See 2005 WL 1412148 (I.R.S.).

B. Initial Taxation of Blue Cross Blue Shield Entities

Capital Blue Cross is a Blue Cross Blue Shield organization that sells health insurance to individuals and groups in central and northeastern Pennsylvania.

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

Related

Highmark Inc. v. United States
Federal Claims, 2022
Wmi Holdings Corp. v. United States
891 F.3d 1016 (Federal Circuit, 2018)
Washington Mutual, Inc. v. United States
856 F.3d 711 (Ninth Circuit, 2017)
Dan Patterson v. Government of the Virgin Islan
597 F. App'x 671 (Third Circuit, 2015)
Washington Mutual, Inc. v. United States
996 F. Supp. 2d 1095 (W.D. Washington, 2014)
Deseret Management Corporation v. United States
112 Fed. Cl. 438 (Federal Claims, 2013)
Walter Anderson v. Commissioner of Internal Reven
698 F.3d 160 (Third Circuit, 2012)
PPL Corp. v. Commissioner
665 F.3d 60 (Third Circuit, 2011)
Gary Adler v. Commissioner of Internal Reven
443 F. App'x 736 (Third Circuit, 2011)
WellPoint, Inc. v. Comm'r
2008 T.C. Memo. 236 (U.S. Tax Court, 2008)
Fisher v. United States
82 Fed. Cl. 780 (Federal Claims, 2008)
Technicolor USA Holdings, Inc. v. Commissioner
288 F. App'x 15 (Third Circuit, 2008)
Swallows Holding v. Comm IRS
Third Circuit, 2008
Swallows Holding, Ltd. v. Commissioner
515 F.3d 162 (Third Circuit, 2008)
Hospital Services Ass'n v. United States
78 Fed. Cl. 434 (Federal Claims, 2007)

Cite This Page — Counsel Stack

Bluebook (online)
431 F.3d 117, 96 A.F.T.R.2d (RIA) 7247, 2005 U.S. App. LEXIS 26474, Counsel Stack Legal Research, https://law.counselstack.com/opinion/capital-blue-cross-and-subsidiaries-v-commissioner-of-internal-revenue-ca3-2005.