Iowa Bankers Benefit Plan v. United States

CourtUnited States Court of Federal Claims
DecidedMay 2, 2019
Docket17-842
StatusPublished

This text of Iowa Bankers Benefit Plan v. United States (Iowa Bankers Benefit Plan 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
Iowa Bankers Benefit Plan v. United States, (uscfc 2019).

Opinion

In the United States Court of Federal Claims No. 17-842T

(Filed: May 2, 2019)

************************************* * IOWA BANKERS BENEFIT PLAN, * * Summary Judgment; RCFC 56; Patient * Protection and Affordable Care Act; Plaintiff, * Annual Fee on Health Insurance * Providers; Covered Entity; Statutory v. * Interpretation; Chevron Deference; * Substantial Variance Rule; Waiver of THE UNITED STATES, * Claims. * Defendant. * * *************************************

Michael A. Gilmer, Davis, Brown, Koehn, Shors & Roberts, P.C., Des Moines, Iowa, for Plaintiff.

Jason Bergmann, Attorney, with whom were Richard E. Zuckerman, Principal Deputy Assistant Attorney General, David I. Pincus, Chief, Mary M. Abate, Assistant Chief, Court of Federal Claims Section, Tax Division, U.S. Department of Justice, Washington, D.C., for Defendant.

OPINION AND ORDER

WHEELER, Judge.

On cross-motions for summary judgment, the Court must decide whether Plaintiff Iowa Bankers Benefit Plan (“the Plan”) is excluded from the Affordable Care Act’s (“ACA”) definition of a “covered entity” subject to the Annual Fee on Health Insurance Providers (“Annual Fee”) either (1) because it is a voluntary employees’ beneficiary association (“VEBA”) “established by an entity (other than by an employer or employers),” Pub. L. 111-148, § 9010(c)(2)(D), or (2) because it constitutes a single employer that self- insures its own employees’ health risks, id. § 9010(c)(2)(A). If the Plan qualifies for either statutory exclusion, it is entitled to a refund of its Annual Fee payments for 2014, 2015, and 2016, a total sum of about $3.7 million. First, the Court concludes that Section 9010(c)(2)(D)’s phrase “established by an entity (other than by an employer or employers)” is ambiguous and that Treasury Regulation 57.2(b)(2)(iv) provides a valid interpretation of that ambiguous phrase. Because 57.2(b)(2)(iv) disqualifies “multiple employer welfare arrangements” (“MEWAs”) from (c)(2)(D)’s Annual Fee exclusion, and the Plan was, at all relevant times, a MEWA, the Plan does not qualify for (c)(2)(D)’s exclusion.

Second, the Court concludes that the Plan waived the argument that it is an employer that self-insures its employees’ health risks under Section 9010(c)(2)(A), because it did not raise the point until its Response and Reply. Moreover, the Plan’s argument fails because it improperly relies on the Employee Retirement Income Security Act’s (“ERISA”) definition of “employer” in trying to persuade the Court that the Plan and its participating employers constitute a single “employer” for purposes of (c)(2)(A).

As a result, the Plan is not entitled to a refund of its Annual Fee payments. The Plan’s cross-motion for summary judgment is DENIED, and the Government’s cross- motion for summary judgment is GRANTED.

Background

I. Iowa Bankers Benefit Plan

The Plan is an entity that provides life, health, vision, and accident insurance, among other benefits, to the employees of financial employers located in Iowa. Pl. Mot. Summ. J. at 6-7. The Plan was established by Iowa Bankers Insurance and Services, Inc. (“IBIS”), an Iowa corporation, which sells insurance products and services to banks and other financial institutions. Id. at 6. IBIS provides a variety of administrative and other services to the Plan. Id. at 9. IBIS is 99.4% owned by the Iowa Bankers Association (“IBA”) and 0.6% owned by banks located in Iowa. Id. at 7. The IBA, IBIS and the Plan are all governed by representatives from financial industry employers located in Iowa. See id. at 7-8. Generally speaking, employees of financial industry employers located in Iowa are eligible to participate in the Plan. Id. at 11-13.

The Plan is both a VEBA and a MEWA. A VEBA is a voluntary employee association “which provides for the payment of life insurance, sickness, accident, or other benefits to its members.” ¶ 9.07 Voluntary Emp. Beneficiary Assoc., Madden, 1999 WL 1031996, 1. Internal Revenue Code (“I.R.C.”) section 501(c)(9) exempts VEBA benefits payments to its members from federal income tax. Id. at 2. Any group of employees that share a qualifying employment-related bond may establish a VEBA, and an employer or employers may establish a VEBA on behalf of their employees. See id. (citations omitted). VEBAs fall under the regulatory purview of the Department of the Treasury (“Treasury”) and the Internal Revenue Service (“IRS”). See id. at 1-3.

2 A MEWA is “an employee welfare benefit plan, or any other arrangement . . ., which is established or maintained for the purpose of offering or providing welfare benefits to the employees of two or more employers.” Filings Required of Multiple Emp’r Welfare Arrangements and Certain Other Related Entities, 78 Fed. Reg. 13781, 13783 (Mar. 1, 2013) (citing 29 U.S.C. § 1002(40)(A)). MEWAs fall under the regulatory purview of the Department of Labor. Id. at 13781. MEWAs do not include plans or arrangements established or maintained pursuant to collective bargaining agreements. Id.

II. The ACA and the Annual Fee on Health Insurance Providers

The ACA, passed in 2010, includes a provision imposing an Annual Fee on “[e]ach covered entity engaged in the business of providing health insurance” in the United States. Pub. L. 111-148, § 9010(a)(1). “‘[C]overed entity’ means any entity which provides health insurance for any United States health risk.” Id. § 9010(c)(1). A statutorily defined formula dictates the amount of each covered entity’s Annual Fee. Id. § 9010(b).

The ACA also contains exclusions from the definition of “covered entity,” and therefore, exclusions from the Annual Fee requirement. Two are relevant here. The first, Section 9010(c)(2)(D), excludes “[a]ny entity which is described in section 501(c)(9) of [the Internal Revenue] Code and which is established by an entity (other than by an employer or employers) for purposes of providing healthcare benefits.” The second, Section 9010(c)(2)(A) excludes “any employer to the extent that such employer self- insures its employees’ health risks[.]” Treasury adopted regulations implementing Section 9010(c)(2)(D)’s exclusion from the definition of “covered entity.” Treas. Reg. § 57.2(b)(2)(iv). Under the regulation, (c)(2)(D)’s exclusion does not include MEWAs. Id.

The Plan paid the Annual Fee for 2014, 2015, and 2016. Pl. Mot. Summ. J. at 5. For each of those years, the Plan requested a refund from the IRS, but the IRS did not respond. Id. at 5. The Plan based each of its refund requests on Section 9010(c)(2)(D). Compl. Ex. A-C. The Plan’s refund requests did not reference (c)(2)(A) at all. See id. Ex. A-C. The Plan’s Complaint also bases its refund claims solely on (c)(2)(D). Id. ¶¶ 1-24.

Procedural History

The Plan filed its Complaint on June 22, 2017. After limited discovery, the Plan and the Government filed cross-motions for summary judgment. Dkt Nos. 32, 35. Briefing concluded on March 8, 2019. Dkt. No. 41. The Court held oral argument on April 9, 2019.

Analysis

The Plan argues that Section 9010(c)(2)(D) excludes it from the definition of “covered entity,” and thus, from the Annual Fee requirement, because it is a VEBA that is not “established . . . by an employer or employers,” but by IBIS, which is almost wholly

3 owned by IBA. Pl. Mot. Summ. J. at 20-23. As a result, the Plan asserts, Treasury Regulation 57.2(b)(2)(iv) must be invalid because it contradicts (c)(2)(D) by disqualifying MEWAs and because it is arbitrary and capricious. Id. at 31-34.

Alternatively, the Plan asserts that it qualifies for Section 9010(c)(2)(A)’s exclusion from the Annual Fee requirement for employers that self-insure their own employees’ health risks. Pl. Resp.

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Iowa Bankers Benefit Plan v. United States, Counsel Stack Legal Research, https://law.counselstack.com/opinion/iowa-bankers-benefit-plan-v-united-states-uscfc-2019.