us-irs-notices-irb-1998-3-pdf•Internal Revenue Bulletin 1998-3 (PDF rendition): IRS Notices
Internal Revenue Bulletin 1998-3 (PDF rendition): IRS Notices
us-irs-notices-irb-1998-3-pdfInternal Revenue Bulletin 1998-3 (PDF rendition): IRS NoticesGuidance
Preserve advance releases and the authoritative Internal Revenue Bulletin rendition; directory timestamps are file-publication metadata, not legal effective dates. HTML bulletins begin June 2003; earlier available issues require full PDF parsing. Whole bulletin rendition: numbered items are identified below; other legal material and publisher context remain included. This is not a new standalone advance release.
EMPLOYEE PLANS Notice 98–1, page 42. Nondiscrimination testing; section 401(k) and section 401(m). This notice describes nondiscrimination testing with respect to cash or deferred arrangements under section 401(k) as well as employer matching and employee contribu- tions under section 401(m) of the Code. EXCISE TAX T.D. 8740, page 4. REG–102894–97, page 59. Temporary and proposed regulations under section 6302 of the Code relate to the availability of the safe harbor deposit rule based on look-back quarter liability and affect persons required to make deposits of excise taxes. T.D. 8741, page 6. REG–109704–97, page 60. Temporary and proposed regulations under section 9812 of the Code relate to mental health parity requirements im- posed on group health plans. ADMINISTRATIVE Rev. Proc. 98–9, page 56. This procedure sets forth the maximum face amount of Qualified Zone Academy Bonds that may be issued for each state in 1998. For this purpose, “state” includes the District of Columbia and the possessions of the United States. Notice 98–3, page 48. Elections under section 7704(g). This notice provides the requirements for making and revoking an election under sec- tion 7704(g) of the Code. This election allows grandfathered publicly traded partnerships to avoid being treated as corpora- tions for federal tax purposes. Notice 98–5, page 49. Foreign tax credit abuse. Treasury and the Service expect to issue regulations that will disallow foreign tax credits for foreign taxes paid or accrued in connection with certain abusive trans- actions. Notice 98–6, page 52. Notice on section 685. Guidance is provided on Qualified Funeral Trust (QFT) eligibility requirements, election procedures, and simplified reporting requirements. Notice 98–7, page 54. Information reporting; interest on education loans. Pay- ees of interest that may be deductible by the payor as qualified education loan interest are informed of their information report- ing requirements for 1998 under section 6050S of the Code, as added by the Taxpayer Relief Act of 1997. Internal Revenue bbuulllleettiinn Bulletin No. 1998–3 January 20, 1998 HIGHLIGHTS OF THIS ISSUE These synopses are intended only as aids to the reader in identifying the subject matter covered. They may not be relied upon as authoritative interpretations. Department of the Treasury Internal Revenue Service Finding Lists begin on page 63. Mission of the Service The purpose of the Internal Revenue Service is to collect the proper amount of tax revenue at the least cost; serve the public by continually improving the quality of our prod- ucts and services; and perform in a manner warranting the highest degree of public confidence in our integrity, effi- ciency, and fairness. 2 Statement of Principles of Internal Revenue Tax Administration The function of the Internal Revenue Service is to adminis- ter the Internal Revenue Code. Tax policy for raising revenue is determined by Congress. With this in mind, it is the duty of the Service to carry out that policy by correctly applying the laws enacted by Congress; to determine the reasonable meaning of various Code provi- sions in light of the Congressional purpose in enacting them; and to perform this work in a fair and impartial manner, with neither a government nor a taxpayer point of view. At the heart of administration is interpretation of the Code. It is the responsibility of each person in the Service, charged with the duty of interpreting the law, to try to find the true meaning of the statutory provision and not to adopt a strained construction in the belief that he or she is “protect- ing the revenue.” The revenue is properly protected only when we ascertain and apply the true meaning of the statute. The Service also has the responsibility of applying and administering the law in a reasonable, practical manner. Issues should only be raised by examining officers when they have merit, never arbitrarily or for trading purposes. At the same time, the examining officer should never hesi- tate to raise a meritorious issue. It is also important that care be exercised not to raise an issue or to ask a court to adopt a position inconsistent with an established Service position. Administration should be both reasonable and vigorous. It should be conducted with as little delay as possible and with great courtesy and considerateness. It should never try to overreach, and should be reasonable within the bounds of law and sound administration. It should, howev- er, be vigorous in requiring compliance with law and it should be relentless in its attack on unreal tax devices and fraud. The Internal Revenue Bulletin is the authoritative instrument of the Commissioner of Internal Revenue for announcing offi- cial rulings and procedures of the Internal Revenue Service and for publishing Treasury Decisions, Executive Orders, Tax Conventions, legislation, court decisions, and other items of general interest. It is published weekly and may be obtained from the Superintendent of Documents on a subscription basis. Bulletin contents of a permanent nature are consoli- dated semiannually into Cumulative Bulletins, which are sold on a single-copy basis. It is the policy of the Service to publish in the Bulletin all sub- stantive rulings necessary to promote a uniform application of the tax laws, including all rulings that supersede, revoke, modify, or amend any of those previously published in the Bulletin. All published rulings apply retroactively unless other- wise indicated. Procedures relating solely to matters of in- ternal management are not published; however, statements of internal practices and procedures that affect the rights and duties of taxpayers are published. Revenue rulings represent the conclusions of the Service on the application of the law to the pivotal facts stated in the revenue ruling. In those based on positions taken in rulings to taxpayers or technical advice to Service field offices, identifying details and information of a confidential nature are deleted to prevent unwarranted invasions of privacy and to comply with statutory requirements. Rulings and procedures reported in the Bulletin do not have the force and effect of Treasury Department Regulations, but they may be used as precedents. Unpublished rulings will not be relied on, used, or cited as precedents by Service personnel in the disposition of other cases. In applying pub- lished rulings and procedures, the effect of subsequent leg- islation, regulations, court decisions, rulings, and proce- dures must be considered, and Service personnel and oth- ers concerned are cautioned against reaching the same con- clusions in other cases unless the facts and circumstances are substantially the same. The Bulletin is divided into four parts as follows: Part I.—1986 Code. This part includes rulings and decisions based on provisions of the Internal Revenue Code of 1986. Part II.—Treaties and Tax Legislation. This part is divided into two subparts as follows: Subpart A, Tax Conventions, and Subpart B, Legislation and Related Committee Reports. Part III.—Administrative, Procedural, and Miscellaneous. To the extent practicable, pertinent cross references to these subjects are contained in the other Parts and Sub- parts. Also included in this part are Bank Secrecy Act Admin- istrative Rulings. Bank Secrecy Act Administrative Rulings are issued by the Department of the Treasury’s Office of the Assistant Secretary (Enforcement). Part IV.—Items of General Interest. With the exception of the Notice of Proposed Rulemaking and the disbarment and suspension list included in this part, none of these announcements are consolidated in the Cumu- lative Bulletins. The first Bulletin for each month includes a cumulative index for the matters published during the preceding months. These monthly indexes are cumulated on a quarterly and semiannual basis, and are published in the first Bulletin of the succeeding quarterly and semiannual period, respectively. 3 Introduction The contents of this publication are not copyrighted and may be reprinted freely. Acitation of the Internal Revenue Bulletin as the source would be appropriate. For sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. Section 901.—Taxes of Foreign Countries and of Possessions of United States Guidance is provided as to whether a foreign tax credit is allowed with respect to foreign taxes paid or accrued in connection with certain abusive trans- actions. See Notice 98–5, page 49. Section 1397E.—Credit to Holders of Qualified Zone Academy Bonds What is the 1998 qualified zone academy bond national limitation for each State, the District of Co- lumbia, and the possessions of the United States? See Rev. Proc. 98–9, page 56. Section 6011.—General Requirement of Return, Statement, or List 26 CFR 301.6011–2T: Required use of magnetic media (temporary). What information reporting requirements apply to payees of education loan interest for 1998 under § 6050S of the Code, as added by the Taxpayer Re- lief Act of 1997. See Notice 98–7, page 54. Section 6050H.—Returns Relating to Mortgage Interest Received in Trade or Business From Individuals 26 CFR 1.6050H–1: Information reporting of mortgage interest received in a trade or business from an individual. What information reporting requirements apply to payees of education loan interest for 1998 (in- cluding those secured by real property) under § 6050S of the Code, as added by the Taxpayer Re- lief Act of 1997. See Notice 98–7, page 54. Section 6302.—Mode or Time of Collection 26 CFR 40.6302(c)–1T: Use of government depositaries (temporary). T.D. 8740 DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 40 Deposits of Excise Taxes AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Temporary regulations. SUMMARY: This document contains temporary regulations relating to the availability of the safe harbor deposit rule based on look-back quarter liability and affects persons required to make deposits of excise taxes. This document also con- tains temporary regulations relating to floor stocks taxes and affects persons li- able for those taxes. The regulations im- plement certain changes made by the Small Business Job Protection Act of 1996 (the 1996 Act) and the Airport and Airway Trust Fund Tax Reinstatement Act of 1997 (the 1997 Act). The text of these regulations also serves as the text of REG–102894–97, page 59. DATES: These regulations are effective December 29, 1997. For dates of applica- bility, see §§40.6302(c)–1Tand 40.6302(c)–2T. FOR FURTHER INFORMATION CON- TACT: Ruth Hoffman (202) 622-3130 (not a toll-free call). SUPPLEMENTARYINFORMATION: Background This document contains amendments to the Excise Tax Procedural Regulations (26 CFR part 40) that implement certain changes made by the 1996 Act and the 1997 Act. The aviation excise taxes that expired on December 31, 1995, were reinstated by the 1996 Act for the period from August 27 through December 31, 1996, by the 1997 Act for the period from March 7 through September 30, 1997, and were extended, with modifications, for the pe- riod from October 1, 1997, through Sep- tember 30, 2007. Deposit Safe Harbor Rules Sections 40.6302(c)–1(c)(2) and 40.6302(c)–2(b)(2) (relating to deposit safe harbors) currently provide, generally, that a person can satisfy excise tax deposit obligations for a calendar quarter by de- positing an amount equal to the person’s excise tax liability reported on the return for the second preceding quarter (the look-back quarter). For this purpose, the tax liability for the look-back quarter must be modified to take into account any increase in rates in the current quarter, but the safe harbor does not specifically ad- dress the effect of the enactment of a new tax or the reinstatement of an expired tax. Notice 97–15, 1997–8 I.R.B. 23, and sec- tion 2(f) of the 1997 Act provide that the look-back safe harbor shall not apply with respect to any tax unless the tax was im- posed throughout the look-back period. The temporary regulations modify the look-back safe harbor rules to reflect this change. Under the temporary regulations, the general look-back safe harbor of §40.6302(c)–1(c)(2) is modified for a class of tax that includes a tax that was not in effect at all times during the look- back quarter (or, in the case of an alterna- tive method tax, that was not in effect at all times during the look-back quarter and the month preceding the look-back quar- ter). The safe harbor does not apply to that class of tax unless, for each semi- monthly period, the deposit is not less than the greater of (1) 1/6 of the net tax li- ability reported for the class of tax for the look-back quarter, or (2) the sum of (i) 95 percent of the net tax liability incurred with respect to new or reinstated taxes during the semimonthly period, and (ii) 1/6 of the net tax liability reported for all other taxes in the class for the look-back quarter. Also, the section 4681 tax (ozone-depleting chemicals) look-back safe harbor provided under §40.6302(c)– 2(b)(2) is modified in a similar manner if the tax liability for the quarter includes li- ability for any chemical that was not sub- ject to tax at all times during the look- back quarter. The new rules apply to liabilities for new or reinstated taxes incurred after Feb- ruary 28, 1997. Fuel Floor Stocks Taxes Section 1609(h) of the 1996 Act im- poses a floor stocks tax on aviation fuel (other than gasoline) on which tax was im- posed by section 4091 before August 27, 1996, and that is held on the first moment January 20, 199841998–3 I.R.B. Part I. Rulings and Decisions Under the Internal Revenue Code of 1986 of that date by any person. Section 2(d) of the 1997 Act imposes a floor stocks tax on aviation gasoline and aviation fuel (other than gasoline) on which tax was imposed by section 4081 or 4091 before March 7, 1997, and that is held on the first moment of that date by any person. The temporary regulations provide that the rules set forth in 26 CFR part 40 (re- lating to administrative provisions for cer- tain excise taxes, including the excise taxes on aviation fuels) also apply to re- lated floor stocks taxes. Thus, persons li- able for floor stocks taxes on aviation fuels must file returns reporting those taxes in accordance with the provisions of 26 CFR part 40. Special Analyses It has been determined that this Trea- sury decision is not a significant regulatory action as defined in EO 12866. Therefore, a regulatory assessment is not required. It also has been determined that section 553(b) of the Administrative Procedure Act (5 U.S.C. chapter 5) does not apply to these regulations and, because these regu- lations do not impose on small entities a collection of information requirement, the Regulatory Flexibility Act (5 U.S.C. chap- ter 6) does not apply. Therefore, a Regula- tory Flexibility Analysis is not required. Pursuant to section 7805(f) of the Internal Revenue Code, these temporary regula- tions will be submitted to the Chief Coun- sel for Advocacy of the Small Business Administration for comment on their im- pact on small business. Drafting Information The principal author of these regula- tions is Ruth Hoffman, Office of Assistant Chief Counsel (Passthroughs and Special Industries). However, other personnel from the IRS and Treasury Department participated in their development. * * * * * Adoption of Amendments to the Regulations Accordingly, 26 CFR part 40 is amended as follows: PART40—EXCISE TAX PROCEDURALREGULATIONS Paragraph 1. The authority citation for part 40 continues to read in part as follows: Authority: 26 U.S.C. 7805 * * * Par. 2. Section 40.0–1Tis added to read as follows: §40.0–1TIntroduction (temporary). (a) through (f). [Reserved] (g) Applicability to floor stocks taxes. The regulations in this part 40 also apply with respect to floor stocks taxes imposed on articles subject to a tax described in §40.0–1(a), beginning April 1, 1991. Par. 3. Section 40.6011(a)–1Tis added to read as follows: §40.6011(a)–1TReturns (temporary). (a)(1) through (a)(2)(ii). [Reserved] (a)(2)(iii) Floor stocks tax return.Are- turn reporting liability for a floor stocks tax described in §40.0–1T(g) is a return for the calendar quarter in which the tax payment is due and not for the calendar quarter in which the liability for tax is in- curred, beginning April 1, 1991. Par. 4. Section 40.6302(c)–1Tis added to read as follows: §40.6302(c)–1TUse of Government depositaries (temporary). (a) through (c)(2)(iii). [Reserved] (c)(2)(iv) Modification for new or rein- stated taxes—(A) Applicability.The safe harbor rule of §40.6302(c)–1(c)(2)(i) is modified for any calendar quarter in which a person’s liability for a class of tax includes liability for any new or reinstated tax. For this purpose, a new or reinstated tax is— (1) Any tax (including an alternative method tax) that was not in effect at all times during the look-back quarter; and (2) Any alternative method tax that was not in effect at all times during the month preceding the look-back quarter. (B) Modification. The safe harbor rule of §40.6302(c)–1(c)(2)(i) does not apply to a class of tax unless the deposit of taxes in that class for each semimonthly period in the calendar quarter is not less than the greater of— (1) 1/6 of the net tax liability reported for the class of tax for the look-back quar- ter; or (2) The sum of— (i) 95 percent of the net tax liability in- curred with respect to new or reinstated taxes during the semimonthly period; and (ii) 1/6 of the net tax liability reported for all other taxes in the class for the look- back quarter. (C) Effective date.This paragraph (c)(2)(iv) applies to tax liabilities for new or reinstated taxes incurred after February 28, 1997, except that paragraph (c)(2)(iv)- (A)(2) of this section applies only for cal- endar quarters beginning after December 31, 1997. (c)(3) through (f)(4). [Reserved] (f)(5) Taxes excluded; floor stocks taxes.No deposit is required in the case of any floor stocks tax described in §40.0–1T(g), beginning April 1, 1991. Par. 5. Section 40.6302(c)-2Tis added to read as follows: §40.6302(c)–2TSpecial rule for use of Government depositaries under section 4681 (temporary). (a) through (b)(2)(ii). [Reserved] (b)(2)(iii) Modification for new chemi- cals—(A) Applicability.The safe harbor rule of §40.6302(c)–2(b)(2)(i) is modified for any calendar quarter in which a per- son’s liability for section 4681 tax includes liability with respect to any new chemical. For this purpose, a new chemical is any chemical that was not subject to tax at all times during the look-back quarter. (B) Modification.The safe harbor rule of §40.6302(c)–2(b)(2)(i) does not apply unless the deposit of section 4681 taxes for each semimonthly period in the calendar quarter is not less than the greater of— (1) 1/6 of the net tax liability reported under section 4681 for the look-back quarter; or (2) The sum of— (i) 95 percent of the net tax liability in- curred under section 4681 with respect to the new chemical during the semimonthly period; and (ii) 1/6 of the net tax liability reported under section 4681 with respect to all other chemicals for the look-back quarter. (C) Effective date.This paragraph (b)(2)(iii) applies to tax liabilities for new chemicals incurred after February 28, 1997. Michael P. Dolan, Acting Commissioner of Internal Revenue. Approved November 6, 1997. Donald C. Lubick, Acting Assistant Secretary of the Treasury. 1998–3 I.R.B5January 20, 1998 January 20, 199861998–3 I.R.B. (Filed by the Office of the Federal Register on De- cember 24, 1997, 8:45 a.m., and published in the issue of the Federal Register for December 29, 1997, 62 F.R. 67568) Section 6721.—Failure to File Correct Information Returns 26 CFR 301.6721–1: Failure to file correct information returns. What information reporting requirements apply to payees of education loan interest for 1998 under § 6050S of the Code, as added by the Taxpayer Re- lief Act in 1997. See Notice 98–7, page 54. Section 6722.—Failure to Furnish Correct Payee Statements 26 CFR 301.6722–1: Failure to furnish correct payee statements. What information reporting requirements apply to payees of education loan interest for 1998 under § 6050S of the Code, as added by the Taxpayer Re- lief Act of 1997. See Notice 98–7, page 54. Section 9812.—Parity in Application of Certain Limits to Mental Health Benefits 26 CFR 54.9812–1T: Parity in the application of certain limits to mental health benefits (temporary). T.D. 8741 DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 54 DEPARTMENT OF LABOR Pension and Welfare Benefits Administration 29 CFR Part 2590 DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Care Financing Administration 45 CFR Part 146 Interim Rules for Mental Health Parity AGENCIES:Internal Revenue Service, Department of the Treasury; Pension and Welfare Benefits Administration, Depart- ment of Labor; Health Care Financing Administration, Department of Health and Human Services. ACTION:Interim rules with request for comments. SUMMARY:This document contains interim rules governing parity between medical/surgical benefits and mental health benefits in group health plans and health insurance coverage offered by issuers in connection with a group health plan. The rules contained in this docu- ment implement changes made to certain provisions of the Internal Revenue Code of 1986 (Code), the Employee Retirement Income Security Act of 1974 (ERISAor Act), and the Public Health Service Act (PHS Act) enacted as part of the Mental Health Parity Act of 1996 (MHPA) and the Taxpayer Relief Act of 1997. Interested persons are invited to submit comments on the interim rules for consid- eration by the Department of the Treasury, the Department of Labor, and the Depart- ment of Health and Human Services (Departments) in developing final rules. The rules contained in this document are being adopted on an interim basis to ensure that sponsors and administrators of group health plans, participants and bene- ficiaries, States, and issuers of group health insurance coverage have timely guidance concerning compliance with the requirements of MHPA. DATES: Effective date.The interim rules are effective January 1,1998. Applicability dates. The requirements of MHPAand the interim rules apply to group health plans and health insurance issuers offering health insurance cover- age in connection with a group health plan for plan years beginning on or after January 1, 1998. MHPAincludes a sun- set provision under which the MHPAre- quirements do not apply to benefits for services furnished on or after September 30, 2001. Information collection.Affected parties are not required to comply with the infor- mation collection requirements in these interim rules until the Departments pub- lish in the Federal Register the control numbers assigned to these information collection requirements by the Office of Management and Budget (OMB). Publi- cation of the control numbers notifies the public that OMB has approved these in- formation collection requirements under the Paperwork Reduction Act of 1995. The Departments have submitted a copy of this rule to OMB for its review of the information collections. Interested per- sons are invited to send comments regard- ing these burdens or any other aspect of these collections of information on or be- fore February 23, 1998. Comments. Written comments on these interim rules are invited and must be re- ceived by the Departments on or before March 23, 1998. ADDRESSES:Comments on the infor- mation collection requirements should be sent directly to: Office of Information and Regulatory Affairs Office of Management and Budget Room 10235 New Executive Office Building Washington, DC 20503 Attention: HCFADesk Officer Health Care Financing Administration Office of Financial and Human Resources Management Planning and Analysis Staff Room C2-26-17 7500 Security Boulevard Baltimore, MD 21244-1850 Attention: John Burke Written comments on other aspects of the interim rules should be submitted with a signed original and three copies (except for electronic submissions sent to the In- ternal Revenue Service (IRS)) to any of the addresses specified below. For conve- nience, comments may be addressed to any of the Departments. Comments ad- dressed to any Department will be shared with the other Departments. Comments to the IRS can be addressed to: CC:DOM:CORP:R (REG–109704–97) Room 5228 Internal Revenue Service POB 7604, Ben Franklin Station Washington, DC 20044. In the alternative, comments may be hand-delivered between the hours of 8 a.m. and 5 p.m. to: CC:DOM:CORP:R (REG–109704–97) Courier’s Desk Internal Revenue Service 1998–3 I.R.B7January 20, 1998 1111 Constitution Avenue, NW Washington DC 20224 Alternatively, taxpayers may transmit comments electronically via the IRS In- ternet site at: http://www.irs.ustreas.gov/ prod/tax_regs/comments.html Comments to the Department of Labor can be addressed to: U.S. Department of Labor Pension and Welfare Benefits Administration 200 Constitution Avenue, NW Room N-5669 Washington, DC 20210 Attention:MHPAComments Alternatively, comments may be hand-de- livered between the hours of 9 a.m. and 5 p.m. to the same address. Comments to the Department of Health and Human Services can be addressed to: Health Care Financing Administration Department of Health and Human Services Attention: HCFA-2891-IFC P.O. Box 26688 Baltimore, MD 21207 In the alternative, comments may be hand-delivered between the hours of 8:30 a.m. and 5:00 p.m. to either: Room 309-G Hubert Humphrey Building 200 Independence Avenue, SW Washington, DC 20201 or Room C5-09-26 7500 Security Boulevard Baltimore, MD 21244-1850 All submissions to the Internal Rev- enue Service will be open to public in- spection and copying in Room 1621, 1111 Constitution Avenue, NW, Washington, DC from 9:00 a.m. to 4:00 p.m. All submissions to the Department of Labor will be open to public inspection and copying in the Public Documents Room, Pension and Welfare Benefits Ad- ministration, U.S. Department of Labor, Room N-5638, 200 Constitution Avenue, NW, Washington, DC from 8:30 a.m. to 5:30 p.m. All submissions to the Department of Health and Human Services will be open to public inspection and copying in Room 309-G of the Department of Health and Human Services offices at 200 Indepen- dence Avenue, SW, Washington, DC from 8:30 a.m. to 5:00 p.m. FOR FURTHER INFORMATION CONTACT:Terese Klitenic, Health Care Financing Administration, Department of Health and Human Services, at (410) 786- 1565; Mark Connor, Pension and Welfare Benefits Administration, Department of Labor, at (202) 219-4377; or Russ Wein- heimer, Internal Revenue Service, Depart- ment of the Treasury, at (202) 622-4695. Customer service information.Individ- uals interested in obtaining a copy of the Department of Labor’s booklet entitled “Questions and Answers: Recent Changes in Health Care Law,” which includes in- formation on MHPA, may call the follow- ing toll-free number: 1-800-998-7542. SUPPLEMENTARY INFORMATION: A. Background The Mental Health Parity Act of 1996 (MHPA) was enacted on September 26, 1996 (Pub. L. 104–204, 110 Stat. 2944). MHPAamended the Employee Retire- ment Income Security Act of 1974 (ERISA) and the Public Health Service Act (PHS Act) to provide for parity in the application of certain dollar limits on mental health benefits with dollar limits on medical/surgical benefits. Provisions implementing MHPAwere later added to the Internal Revenue Code of 1986 (Code) under the Taxpayer Relief Act of 1997 (Pub. L. 105–34). 1. Regulatory Responsibility The provisions of MHPAare set forth in Chapter 100 of Subtitle K of the Code, Part 7 of Subtitle B of Title I of ERISA, and Title XXVII of the PHS Act. 1 The Secretaries of the Treasury, Labor, and Health and Human Services share juris- diction over the MHPAprovisions. These provisions are substantially similar, ex- cept as follows: •The MHPAprovisions in the Code gener- ally apply to all group health plans other than governmental plans, but they do not apply to health insurance issuers. Atax- payer that fails to comply with these pro- visions may be subject to an excise tax under section 4980D of the Code. •The MHPAprovisions in ERISAgener- ally apply to all group health plans other than governmental plans, church plans, and certain other plans. These provisions also apply to health insur- ance issuers that offer health insurance coverage in connection with such group health plans. Generally, the Sec- retary of Labor enforces the MHPA provisions in ERISA, except that no enforcement action may be taken by the Secretary against issuers. How- ever, individuals may generally pursue actions against issuers under ERISA and, in some circumstances, under State law. •The MHPAprovisions in the PHS Act generally apply to health insurance is- suers that offer health insurance cover- age in connection with group health plans and to certain State and local governmental plans. States, in the first instance, enforce the PHS Act with re- spect to issuers. Only if a State does not substantially enforce any provi- sions under its insurance laws will the Department of Health and Human Ser- vices enforce the provisions, through the imposition of civil money penalties. Moreover, no enforcement action may be taken by the Secretary of Health and Human Services against any group health plan except certain State and local governmental plans. The interim rules being issued today by the Secretaries of the Treasury, Labor, and Health and Human Services have been developed on a coordinated basis by the Departments. In addition, these interim rules take into account comments re- ceived by the Departments in response to the request for public comments on MHPApublished in the Federal Register on June 26, 1997 (62 FR 34604). Except to the extent needed to reflect the statu- tory differences described above, the in- terim rules of each Department are sub- stantively identical. However, there are certain non-substantive differences. The interim rules reflect certain stylistic dif- ferences in language and structure to con- form to conventions used by a particular Department. These differences have been minimized and any differences in word- 1 Chapter 100 of Subtitle K of the Code, Part 7 of Subtitle B of Title I of ERISA, and Title XXVII of the PHS Act were added by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Pub. L. 104–191. January 20, 199881998–3 I.R.B. ing are not intended to create any substan- tive difference. 2. Preemption of State Laws The McCarran-Ferguson Act of 1945 (Pub. L. 79–15) exempts the business of insurance from federal antitrust regulation to the extent that it is regulated by the States and indicates that no federal law should be interpreted as overriding State insurance regulation unless it does so ex- plicitly. Section 514(a) of ERISApre- empts State laws relating to employee benefit plans (including group health plans). Section 731 of ERISAand sec- tion 2723 of the PHS Act provide that Part 7 of Subtitle B of Title I of ERISAand Part Aof Title XXVII of the PHS Act (in- cluding the MHPAprovisions) do not in any way affect or modify section 514 of ERISAwith respect to group health plans. Section 514(b)(2) of ERISAsaves from preemption any State law that regulates insurance. However, section 731(a) of ERISAand section 2723(a) of the PHS Act preempt State insurance laws relating to health insurance issuers in connection with group health insurance coverage to the extent such laws “prevent the applica- tion of” Part 7 of Subtitle B of Title I of ERISAor Part Aof Title XXVII of the PHS Act, including the MHPAprovisions. (There is no corresponding provision in the Code.) In this regard, the conference report to HIPAAstates that the conferees generally intended the narrowest preemp- tion of State laws with regard to health in- surance issuers (not group health plans) with respect to the provisions of Part 7 of Subtitle B of Title I of ERISAand Part A of Title XXVII of the PHS Act. 2 Conse- quently, the conference report to HIPAA states that State laws with regard to health insurance issuers that are broader than federal requirements in certain areas would not “prevent the application of” the provisions of Part 7 of Subtitle B of Title I of ERISAor Part Aof Title XXVII of the PHS Act. Further, the conference report to MHPAstates that the application of these preemption provisions should permit the operation of any State law or provision that requires more favorable treatment of mental health benefits under health insurance coverage than that re- quired under the MHPAprovisions. Thus, generally, a State law that re- quires more favorable treatment of mental health benefits under health insurance coverage offered by issuers would not be preempted by the provisions of MHPA and the interim rules. B. Overview of MHPAand the Interim Rules The MHPAprovisions are set forth in section 9812 of the Code, section 712 of ERISA, and section 2705 of the PHS Act. MHPAand the interim rules apply to a group health plan (or health insurance coverage offered by issuers in connection with a group health plan) that provides both medical/surgical benefits and mental health benefits. The MHPAprovisions provide for par- ity in the application of aggregate lifetime dollar limits, and annual dollar limits, be- tween mental health benefits and med- ical/surgical benefits. If a group health plan offers two or more benefit packages under the plan, the requirements of MHPAand the interim rules apply sepa- rately to each package. The interim rules make clear that the MHPArequirements apply regardless of whether the mental health benefits are administered sepa- rately under the plan. In addition, the in- terim rules make clear that the MHPAre- quirements in ERISAand the PHS Act apply both to group health plans and to health insurance issuers offering coverage in connection with a group health plan. MHPAand the interim rules do not re- quire a group health plan (or health insur- ance coverage offered in connection with a group health plan) to provide mental health benefits. In addition, MHPAand the interim rules do not affect the terms and conditions (including cost sharing, limits on the number of visits or days of coverage, requirements relating to med- ical necessity, requirements that patients or providers obtain prior authorization for treatment, and requirements relating to primary care physicians’referrals for treatment) relating to the amount, dura- tion, or scope of mental health benefits under a plan (or coverage) except as specifically provided in regard to parity of aggregate lifetime dollar limits and an- nual dollar limits. 3 1.Aggregate Lifetime Limits and Annual Limits Under MHPAand the interim rules, a group health plan (or health insurance coverage offered in connection with a group health plan) providing both med- ical/surgical benefits and mental health benefits may comply with the MHPApar- ity requirements in any of the following general ways: •The plan (or coverage) may comply by not including any aggregate lifetime dollar limit or annual dollar limit on mental health benefits. •The plan (or coverage) may comply by imposing a single aggregate lifetime or annual dollar limit on both medical/sur- gical benefits and mental health bene- fits in a way that does not distinguish between the two. •The plan (or coverage) may comply by imposing an aggregate lifetime dollar limit or annual dollar limit on mental health benefits that is not less than the aggregate lifetime dollar limit or annual dollar limit on medical/surgical benefits. •In the case of a plan (or coverage) under which aggregate lifetime dollar limits or annual dollar limits differ for cate- gories of medical/surgical benefits, the plan (or coverage) may comply by cal- culating a weighted average aggregate lifetime dollar limit or weighted aver- age annual dollar limit for mental health benefits. The weighted average must be based on a formula in the interim rules that takes into account the limits on different categories of medical/sur- gical benefits. In addition, under MHPAand the interim rules, benefits for treatment of substance abuse or chemical dependency may not be 2 However, the preemption is broader for the statuto- ry requirements of section 701 of ERISAand section 2701 of the PHS Act that limit the application of pre- existing condition exclusions. Under these broader provisions, State laws cannot “differ” from the pre- existing condition exclusion requirements of section 701 of ERISAor section 2701 of the PHS Act except as specifically permitted by section 721(b)(2) of ERISAand section 2723(b)(2) of the PHS Act. These provisions permit a State to impose on health insurance issuers certain stricter limitations relating to preexisting condition exclusions. 3 In response to the Departments’request for public comments on MHPApublished in the Federal Register(62 FR 34604), the Equal Employment Opportunity Commission (EEOC) noted that the Americans with Disabilities Act (ADA) prohibits disability-based distinctions (including such distinc- tions relating to the provision of mental health bene- fits) in employer-provided health insurance plans unless the plan otherwise falls within the protections of sectin 501(c) of the ADA. The aDAis within the regulatory jurisdiction of the EEOC. 1998–3 I.R.B9January 20, 1998 counted in applying an aggregate lifetime or annual dollar limit that applies sepa- rately to mental health benefits. 2.Exemptions from the Requirements of MHPA (a) Small Employer Exemption The parity requirements under MHPA and the interim rules do not apply to any group health plan (or health insurance coverage offered in connection with a group health plan) for any plan year of a small employer. The term “small em- ployer” is defined as an employer who employed an average of at least 2 but not more than 50 employees on business days during the preceding calendar year and who employs at least 2 employees on the first day of the plan year. 4 For purposes of the small employer ex- emption, all persons treated as a single employer under subsections (b), (c), (m), and (o) of section 414 of the Code (26 U.S.C. 414) are treated as one employer. In addition, if an employer was not in ex- istence throughout the preceding calendar year, whether the employer is a small em- ployer is determined on the average num- ber of employees the employer reason- ably expects to employ on business days during the current calendar year. Finally, any reference to an employer in the small employer exemption includes a reference to a predecessor of the employer. (b) Increased Cost Exemption The second exemption from the MHPA requirements applies to group health plans (or health insurance coverage of- fered in connection with a group health plan) if the application of the MHPApar- ity requirements described in paragraph (b)(1)(i) 5 results in an increase in the cost under the plan (or coverage) of at least one percent. This exemption is available only if the requirements of paragraph (f) are met. If a plan offers more than one benefit package, the exemption is applied separately to each benefit package. Ex- cept as provided in the transition period described in paragraph (h), a plan must implement the parity requirements for the first plan year beginning on or after Janu- ary 1, 1998, and must continue to comply with the parity requirements until Sep- tember 30, 2001 (the sunset date in para- graph (i)) unless the plan satisfies the ex- emption described in paragraph (f). However, the exemption is not effective until 30 days after the notice requirements in paragraph (f)(3) are satisfied. The interim rules, in paragraph (f)(2), describe the ratio of two terms used to de- termine if a plan (or coverage) has experi- enced a cost increase of one percent or more. The first term is the total cost in- curred under parity (including both men- tal health costs and medical/surgical costs). The second term is the total cost incurred under parity reduced by the costs required solely to comply with parity. Costs required solely to comply with par- ity include mental health claims that would have been denied absent amend- ments required to comply with parity, the administrative costs related to those claims, and other administrative costs at- tributable to complying with the parity re- quirements. Premium payments are not considered in this calculation. The ratio is expressed by the following formula: IE ≥1.01000 IE – (CE + AE) IE represents the incurred expenditures during the base period. CErepresents the claims incurred during the base period that would have been denied under the terms of the plan absent plan amendments required to comply with the parity re- quirements of paragraph (b)(1)(i). AE represents administrative costs related to claims in CEand other administrative costs attributable to complying with the parity requirements of paragraph (b)(1)(i). Examples illustrate how the rule is ap- plied in the case of a self-funded plan, a fully insured plan, and a partially insured plan. Moreover, in the case of a partially insured plan in which the partially insured portion is pooled for rating purposes, the costs of the pool should be allocated pro- portionally among the pool members by reasonable methods, including propor- tional enrollment. Additional provisions in paragraph (f) describe the baseline for determining those costs that are attribut- able solely to compliance with the parity requirements, the base period used to cal- culate whether a plan may claim the ex- emption, and how long the exemption ap- plies once it is claimed. The base period must begin on the first day in any plan year that the plan complies with the re- quirements of paragraph (b)(1)(i) of this section and must extend for a period of at least six consecutive calendar months. However, in no event may the base period begin prior to September 26, 1996 (the date of enactment of the Mental Health Parity Act (Pub. L. 104–204, 110 Stat. 2944)). Before a group health plan may claim the one-percent increased cost exemption, it must furnish participants and beneficiaries with a notice of the plan’s exemption from the parity requirements that includes the information described in paragraph (f)(3)(i). Aplan may satisfy this requirement by providing participants and beneficiaries with a summary of mate- rial reductions in covered services or ben- efits, under 29 CFR 2520.104b–3(d), if it includes all the information required by paragraph (f)(3)(i). However, this exemp- tion under MHPAis not effective until at least 30 days after the notice is sent to the participants and beneficiaries and the ap- propriate federal agency even if the notice is incorporated into a summary of material reductions in covered services or benefits. Agroup health plan that is not subject to Part 7 of Subtitle B of Title I of ERISA, and a plan subject to Part 7 of Subtitle B of Title I of ERISAthat chooses not to in- corporate the information in paragraph (f)(3)(i) into a summary of material re- ductions in covered services or benefits (which must be furnished to participants and beneficiaries and the appropriate fed- eral agency), may use the following model to satisfy the notice requirement under paragraph (f)(3) of the interim rules: 4 Section 9831(a) of the Code, section 732(a) of ERISA, and section 2721(a) of the PHS Act provide an exception that applies under the MHPAprovi- sions as well as under provisions added by HIPAA and the Newborns’and Mothers’Health Protection Act of 1996. The exception applies to any group health plan (and health insurance coverage offered in connection with a group health plan) for any plan year if, on the first day of the plan year, the plan has fewer than 2 participants who are current employees. 5 Any reference to a particular paragraph in this pre- amble to the interim rules is a reference to the corre- sponding paragraphs in each of the Departments’ interim rules. To claim the one-percent increased cost exemption, a group health plan that is a church plan (as defined in section 414(e) of the Code) also must furnish to the De- partment of the Treasury a copy of the no- tice sent to participants and beneficiaries that satisfies the requirements of para- graph (f)(3)(i). To claim the one percent increased cost exemption, a group health plan subject to Part 7 of Subtitle B of Title I of ERISAalso must furnish to the De- partment of Labor a copy of the notice sent to participants and beneficiaries that satisfies the requirements of paragraph (f)(3)(i). To claim the one percent in- creased cost exemption, a group health plan that is a nonfederal governmental plan also must furnish to the Department of Health and Human Services a copy of the notice sent to participants and benefi- ciaries that satisfies the requirements of paragraph (f)(3)(i). In all cases, the ex- emption is not effective until 30 days after notice has been sent both to participants and beneficiaries and to the appropriate federal agency. Any notice submitted to the Department of Labor or Health and Human Services will be available for pub- lic inspection. The Secretaries have designated the following addresses for delivery of these notices: For notices to the Department of the Trea- sury, church plans should mail the notice to: Office of the Assistant Commissioner, Examination Examination Programs CP:EX:E 1111 Constitution Avenue, NW Washington, DC 20224 Attention: MHPAone-percent cost exemption notice For notices to the Department of Labor, plans should mail the notice to: Public Documents Room Pension and Welfare Benefits Administration January 20, 1998101998–3 I.R.B. NOTICE OF GROUP HEALTH PLAN’S EXEMPTION FROM THE MENTAL HEALTH PARITYACT * DESCRIPTION OFTHE ONE PERCENTINCREASED COSTEXEMPTION — This notice is required to be pro- vided to you underthe requirements of the Mental Health Parity Act of 1996 (MHPA) because the group health plan identified in Line 1 below is claiming the one percent increased cost exemption from the requirements of MHPA. Under MHPA, a group health plan offering both medical/surgical and mental health benefits generally can no longerset annual oraggregate lifetime dollarlimits on mental health benefits that are lowerthan any such dollarlimits formedical/surgi- cal benefits. In addition, a plan that does not impose an annual oraggregate lifetime dollarlimit on medical/surgical ben- efits generally may not impose such a limit on mental health benefits. However, a group health plan can claim an ex- emption from these requirements if the plan’s costs increase one percent ormore due to the application of MHPA’s requirements. This notice is to inform you that the group health plan identified in Line 1 below is claiming the exemption from the re- quirements of MHPA. The exemption is effective as of the date identified in Line 4 below. Since benefits underyour group health plan may change as of the date identified in Line 4 it is important that you contact yourplan administrator orthe plan representative identified in Line 5 below to see how yourbenefits may be affected as a result of yourgroup health plan’s election of this exemption from the requirements of MHPA. Upon submission of this notice by you (oryourrepresentative) to the plan administratororthe person identified in Line 5 below, the plan will provide you oryourrepresentative, free of charge, a summary of the information upon which the plan’s exemption is based. 1. Name of the group health plan and the plan number (PN): ______________________________________ 2. Name, address, and telephone number of plan administrator responsible for providing this notice: ______________________________________________ ______________________________________________ ______________________________________________ 3. For single-employer plans, the name, address, telephone number, (if different from Line 2) and employer identification num- ber (EIN) of the employer sponsoring the group health plan: ______________________________________________ ______________________________________________ ______________________________________________ 4. Effective date of the exemption (at least 30 days after the notices are sent): __________________________________ 5. For further information, call: __________________________________ 1998–3 I.R.B11January 20, 1998 U.S. Department of Labor Room N-5638 200 Constitution Avenue, NW Washington, DC 20210 Attention: MHPAone-percent cost exemption notice For notices to the Department of Health and Human Services, plans should mail the notice to: Health Care Financing Administration 7500 Security Boulevard Baltimore, MD 21244-1850 Attention: Insurance Standards: Exemptions Finally, to claim the one percent in- creased cost exemption, a plan (or issuer) must make available to participants and beneficiaries (or their representatives), on request and at no charge, a summary of the information described in paragraph (f)(4). An individual who is not a partici- pant or beneficiary and who presents a notice described in paragraph (f)(3)(i) is considered to be a representative. For this purpose, individually identifiable infor- mation in the notice may be redacted. The summary of information must in- clude the incurred expenditures, the base period, the dollar amount of claims in- curred during the base period that would have been denied under the terms of the plan absent amendments required to com- ply with parity, and the administrative ex- penses attributable to complying with the parity requirements. In no event should a summary of information include individu- ally identifiable information. Civil money penalties as described in regulations at 45 CFR 146.184(d) apply to an issuer or nonfederal governmental plan that fails to satisfy the requirements of paragraph (f). 3. MHPA’s Effective Date and Sunset Provision The MHPAprovisions are generally effective for group health plans (and health insurance issuers offering health insurance coverage in connection with a group health plan) for plan years begin- ning on or after January 1, 1998. MHPA includes a sunset provision under which the MHPArequirements do not apply to benefits for services furnished on or after September 30, 2001. However, for requirements of this sec- tion other than the one-percent increased cost exemption, the interim rules provide a limitation on enforcement actions in paragraph (h)(2). Under that paragraph, no enforcement action can be taken by any of the Secretaries against a group health plan (or issuer) that has sought to comply in good faith with the require- ments of section 9812 of the Code, sec- tion 712 of ERISA, and section 2705 of the PHS Act with respect to a violation that occurs before the earlier of the first day of the first plan year beginning on or after April 1, 1998, or January 1, 1999. Compliance with the requirements of the interim rules is deemed to be good faith compliance with the requirements of sec- tion 9812 of the Code, section 712 of ERISA, and section 2705 of the PHS Act. With respect to the increased cost ex- emption, the interim rules provide in paragraph (h)(3) a transition period for compliance with the requirements of paragraph (f). Under paragraph (h)(3), no enforcement action will be taken against a group health plan (or issuer) that is sub- ject to the MHPArequirements prior to April 1, 1998 solely because the plan has claimed the increased cost exemption under section 9812(c)(2) of the Code, sec- tion 712(c)(2) of ERISA, or section 2705(c)(2) of the PHS Act based on as- sumptions inconsistent with the rules under paragraph (f) of the interim rules, provided that the plan is amended to com- ply with the parity requirements no later than March 31, 1998 and the plan com- plies with the notice requirements in para- graph (h)(3)(ii). Agroup health plan satisfies this transi- tion period notice requirement only if the plan provides notice to the applicable fed- eral agency and posts such notice at the location(s) where documents must be made available for examination under section 104(b)(2) of ERISAand the regu- lations thereunder (§2520.104b–1(b)(3)). The notice must indicate the plan’s intent to use the transition period by 30 days after the first day of the plan year begin- ning on or after January 1, 1998, but in no event later than March 31, 1998. For a group health plan that is a church plan, the applicable federal agency is the De- partment of the Treasury. For a group health plan that is subject to Part 7 of Sub- title B of Title I of ERISA, the applicable federal agency is the Department of Labor. For a group health plan that is a nonfederal governmental plan, the applic- able federal agency is the Department of Health and Human Services. In all cases, the notice must include the date; the name of the plan and the plan number; the name, address, and telephone number of the plan sponsor or plan administrator; the employer identification number (in the case of single-employer plans only); the individual to contact for further informa- tion; the signature of the plan administra- tor; and the date signed. In addition, the notice must be provided at no charge to participants and beneficiaries (or their representatives) within 15 days after re- ceipt of a written or oral request for such notification, but in no event does the no- tice have to be provided before it has been sent to the applicable federal agency. For this purpose, plans may use the following model: The Secretaries have designated the following addresses for delivery of the notices: For notices to the Department of the Trea- sury, plans should mail the notice to: Office of the Assistant Commissioner, Examination Examination Programs CP:EX:E 1111 Constitution Avenue, NW Washington, DC 20224 Attention: MHPAtransition period notice For notices to the Department of the Labor, plans should mail the notice to: Public Documents Room Pension and Welfare Benefits Administration U.S. Department of Labor Room N-5638 200 Constitution Avenue, NW Washington, DC 20210 Attention: MHPAtransition period notice For notices to the Department of Health and Human Services, plans should mail the notice to: Health Care Financing Administration 7500 Security Boulevard Baltimore, MD 21244-1850 Attention: Insurance Standards: Exemptions C. Interim Rules and Request for Comments Section 9833 of the Code (formerly section 9806), section 734 of ERISA(for- merly section 707), and section 2792 of the PHS Act provide, in part, that the Sec- retaries of the Treasury, Labor, and Health and Human Services may promulgate any interim final rules as they determine are appropriate to carry out the provisions of Chapter 100 of Subtitle K of the Code, Part 7 of Subtitle B of Title I of ERISA, and Part Aof Title XXVII of the PHS Act, including the MHPAprovisions. Under Section 553(b) of the Adminis- trative Procedure Act (5 U.S.C. 551 et seq.) a general notice of proposed rule- making is not required when an agency, for good cause, finds that notice and pub- lic comment thereon are impracticable, unnecessary, or contrary to the public in- terest. These rules are being adopted on an in- terim final basis because the Secretaries have determined that without prompt guidance some members of the regulated community may not know what steps to take to comply with the MHPArequire- ments, which may result in an adverse im- pact on participants and beneficiaries with regard to their mental health benefits under group health plans and the protec- tions provided under MHPA. Moreover, January 20, 1998121998–3 I.R.B. NOTICE OF GROUP HEALTH PLAN’S USE OF TRANSITION PERIOD * IMPORTANT— This notice is required to be provided if a group health plan uses the transition period underthe re- quirements of the Mental Health Parity Act (MHPA). UnderMHPA, a group health plan offering both medical/surgical and mental health benefits generally can no longerset annual oraggregate lifetime dollarlimits on mental health benefits that are lowerthan any such dollarlimits formedical/surgical benefits. In addition, a plan that does not impose an annual oraggregate lifetime dollarlimit on medical/surgical benefits generally may not impose such a limit on mental health ben- efits. However, a group health plan can claim an exemption from these requirements if the plan’s costs increase one per- cent ormore due to the application of MHPA’s requirements. UnderMHPA, a plan that claimed the one percent in- creased cost exemption priorto the issuance of the MHPAinterim regulations based on assumptions inconsistent with the MHPAinterim regulations may delay compliance with the parity requirements of MHPAuntil a date no laterthan March 31, 1998. This notice is to inform you that the plan is utilizing the MHPAtransition period and that the plan is delaying compliance with the parity requirements of MHPAuntil a time no laterthan March 31, 1998. 1. Name of the group health plan and the plan number (PN): ______________________________________ 2. Name, address, and telephone number of plan administrator responsible for providing this notice: ______________________________________________ ______________________________________________ ______________________________________________ 3. For single-employer plans, the name, address, telephone number, (if different from Line 2), and employer identification num- ber (EIN) of the employer sponsoring the group health plan: ______________________________________________ ______________________________________________ ______________________________________________ 4. For further information, call: ______________________________________________ 5. Signature of plan administrator: _____________________________________ Date: _____________ 1998–3 I.R.B13January 20, 1998 MHPA’s requirements will affect the reg- ulated community in the immediate fu- ture. MHPA’s requirements are effective for all group health plans and for health in- surance issuers offering coverage in con- nection with such plans for plan years be- ginning on or after January 1, 1998. Plan administrators and sponsors, issuers, and participants and beneficiaries, will need guidance on the new statutory provisions before MHPA’s effective date. As noted earlier, these interim rules take into ac- count comments received by the Depart- ments in response to the request for public comments on MHPApublished in the Federal Registeron June 26, 1997 (62 FR 34604). For the foregoing reasons, the Departments find that the publication of a proposed regulation, for the purpose of notice and public comment thereon, would be impracticable, unnecessary, and contrary to the public interest. D. Regulatory Flexibility Act The Regulatory Flexibility Act (5 U.S.C. 601 et. seq.)(RFA) requires an agency to publish a regulatory flexibility analysis describing the impact of a pro- posed rule which the agency determines would have a significant impact on a sub- stantial number of small entities. The RFArequires that the agency present an initial regulatory flexibility analysis and seek public comment on its analysis when the agency publishes a general notice of proposed rulemaking (NPRM) under sec- tion 553 of the Administrative Procedures Act (5 U.S.C. 553 et seq.) (APA). Under the RFA, small entities include small businesses, non-profit organizations and governmental agencies. For our pur- poses, under the RFA, States and individ- uals are not considered small entities. However, small employers and small group health plans are considered small entities. Since these rules are issued as interim final rules, and not as an NPRM, a formal regulatory flexibility analysis has not been prepared. Nonetheless, in the dis- cussion below on the rule’s impact on the regulated community, the Departments present an analysis addressing many of the same issues otherwise required by the RFA, including the likely impact of the interim rule on small entities, and a dis- cussion of regulatory alternatives consid- ered in crafting the rule. The Depart- ments invite interested persons to submit comments for consideration in the devel- opment of the final rules implementing the MHPA. Consistent with the RFA, the Departments encourage the public to sub- mit comments that accomplish the stated purpose of the MHPAand minimize the impact on small entities. Specifically, we welcome comments addressing the im- pact of the MHPA’s 1 percent cost exemp- tion for plans and issuers that can demon- strate that implementation of the parity rules would raise their expenditures by more than one percent. We also welcome comments addressing the operation of the MHPAprovision requiring that plans using differential aggregate lifetime or annual limits for various categories of benefits use a weighted average of such differential limits to calculate the overall aggregate lifetime and annual limits for the plan. E. Executive Order12866 — Departments of Laborand Health and Human Services The Office of Management and Budget has determined this rule to be a major rule, as well as an economically signifi- cant regulatory action under Section 3(f) of Executive Order 12866. The following analysis fulfils the requirement under the Executive Order to assess the economic impact of major and economically signifi- cant regulatory actions. Executive Order 12866 requires agen- cies to assess the costs and benefits of available regulatory alternatives, and when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects; distributive impacts; and equity). Section 3(f) of the Executive Order 12866 requires agencies to prepare a regulatory impact analysis for any rule which is deemed a “significant regulatory action” according to specified criteria, including whether the rule may have an annual ef- fect on the economy of $100 million or more or certain other specified effects; or whether the rules raise novel legal or pol- icy issues arising out of the President’s priorities. This analysis was conducted by the De- partments of Labor and Health and Human Services. It discusses the eco- nomic impact of the MHPA, which this rule implements, with special emphasis on the one percent cost exemption. It quantifies the number of plans and indi- viduals who might be affected by the ex- emption rule, illustrating the exemption’s effect in the context of other statutory MHPAprovisions. It separately considers the impact of regulatory discretion exer- cised by the Departments in connection with this rule. a.Overall Impact of the MHPA In general, the MHPAmay have both direct and indirect effects on group health plans, plan sponsors, and plan partici- pants. Direct effects may include broader coverage of mental health treatments and associated increases in mental health ben- efit payments. Indirect effects may in- clude the steps employers who sponsor plans may take to reduce or offset their expenditures attributable to compliance with the MHPA, such as amending, cur- tailing or dropping mental health benefits or other components of compensation, as well as participants’responses to any ex- penditure increases that are passed to them. Direct Effects The most direct effect of the MHPAis broader health insurance coverage for mental health treatment. In many health plans, mental health coverage is more re- strictive than medical/surgical coverage due to lower annual and/or lifetime dollar limits, more restrictive limits on visits and stays, and other plan provisions. For ex- ample, a recent survey of employee bene- fit plans by Hay/Huggins illustrates the differences in plan terms and lower dollar limits of mental health services and med- ical/surgical services. The survey re- ported that indemnity plans typically im- pose a lifetime limit of $50,000 for mental health benefits. On the other hand, medical/surgical benefits of a typi- cal indemnity plan provide a lifetime limit of $1,000,000. Requiring fuller coverage of mental health treatment will increase mental health benefit payments and associated plan expenditures. Some of this increase will be paid by plan sponsors, and some will be paid by participants in the form of increased premiums and/or reductions in January 20, 1998141998–3 I.R.B. other compensation. Aside from any in- creased administrative costs involved, these plan expenditure increases generally represent one side of transfer payments rather than erosion in overall social wel- fare. In other words, additional plan ex- penditures arising from the MHPAare balanced by additional benefits paid for mental health services. One result will be that some money that would have been spent on other goods or services will be spent instead on mental health services. The direct effects of the MHPAwill in turn cause other effects due to subsequent responses by affected employers (in their capacity as plans sponsors) and partici- pants. Indirect Effects of the MHPA There are numerous ways in which plan sponsors affected by the MHPA might react. Some might take no action other than to remove or increase dollar limits on mental health benefits. Others might make other changes to their mental health benefits in order to reduce or offset expenditure increases from compliance with MHPA. The statute explicitly pre- serves plan sponsors’right to provide no mental health benefits, or to set the “terms and conditions (including cost sharing, limits on numbers of visits or days of cov- erage, and requirements relating to med- ical necessity) relating to the amount, du- ration, or scope of mental health benefits,” except with respect to annual or lifetime dollar limits. Some plan design options would be associated with lower plan expenditure increases from compli- ance with the MHPA. The statute also provides an “increased cost exemption” under which the statute “shall not apply” if its application “results in an increase in the cost . . . of at least 1 percent” (ERISA Section 712(c)(2)). Plan sponsors’re- sponses to the MHPAmay lessen their ex- penditures associated with compliance; that is, their responses may reduce the amount of transfers arising from the MHPA. For example, many mental health plans currently have non-dollar limits. Accord- ing to the U.S. Bureau of Labor Statistics, among full-time participants at private es- tablishments with 100 or more employees in 1993, 55 percent were subject to sepa- rate day limits for inpatient mental health treatment, and 43 percent were subject to separate visit limits for outpatient mental health treatment (U.S. Bureau of Labor Statistics, Employee Benefits in Medium and Large Private Establishments, 1993). Plans that impose non-dollar limits on mental health benefits may face smaller expenditures increases from the MHPA. Many plans currently subject mental health benefits to separate cost sharing provisions. Among full-time participants in medium and large private establish- ments in 1993, 15 percent were subject to separate coinsurance rates and 4 percent were subject to separate copayment rates for inpatient mental health care, while 53 percent and 18 percent were respectively subject to separate coinsurance and co- payment rates for outpatient mental health care. Cost sharing generally affects plan expenditures in two ways. First, by shift- ing some payments for services to partici- pants, cost sharing directly reduces the expenditures borne by plans. Second, by increasing the price of services faced by participants, cost sharing reduces the quantity of services that participants de- mand. Because of both of these mecha- nisms, plans that have more cost sharing for mental health benefits will not be im- pacted as much by the MHPAas plans that have parity in cost sharing. Many plans use HMO-style manage- ment techniques to control mental health benefit expenditures. Plans that have HMO-style mental health “carve-outs” but no mental health limits are likely to pay less for mental health benefits than fee-for-service plans with low dollar lim- its that are impermissible under the MHPA. For example, a FFS plan with utilization review and an annual mental health limit of $10,000 averages $6.51 per member per month, while an unlimited “carve out” plan pays $6.12, according to a Price Waterhouse LLPactuarial model developed for the Departments based on the same data as above. There are a number of reasons why the permissible plan designs outlined here should have little negative effect on exist- ing mental health coverage. First, the modest expenditure increases necessitated by the MHPAwould be unlikely to prompt many major design changes. As noted below, approximately 10 percent of affected plans will face increased expen- ditures under the MHPAof at least one percent, according to the Price Water- house, LLPanalysis conducted for the Departments. Only 4 percent of affected plans are expected to be faced with in- creases from the MHPAof 1.5 percent or more, according to the same analysis. Second, the largest expenditure increases and therefore the most aggressive re- sponses will be associated with plans that have the tightest dollar caps today—that is, with plans that would have provided the most restrictive coverage anyway. Other effects resulting from the MHPA may include plan sponsors dropping men- tal health coverage altogether, or drop- ping or curtailing other health benefits or components of compensation. Such cur- tailments could include shifting some of the cost of benefits to employees, for ex- ample in the form of increased participant premium contributions for health bene- fits. Participants, in turn, might respond to premium increases by dropping their health benefits or electing less expensive plans. As with plan sponsor amendments to mental health benefits, such responses by plan sponsors and participants are ex- pected to be modest and/or rare, given the generally small direct effects of the MHPAon plan expenditures. b.Review of Quantitative Estimates The Congressional Budget Office (CBO) estimated that the MHPA’s direct effect would be to increase health plan ex- penditures by 0.4 percent on aggregate. (See Congressional Budget Office, “CBOs Estimates of the Mental Health Parity Amendments to the VA/HUD Ap- propriation Bill, as Passed in the Senate,” September 10, 1996.) This assumes that plan sponsors make no changes to their plans other than to raise or eliminate dol- lar limits on mental health benefits con- sistent with the MHPA’s parity require- ments. However, some plan sponsors may make other changes to their plans in order to reduce or offset the impact of the MHPAon their expenditures. For exam- ple, some plan sponsors might amend, curtail, or drop mental health benefits or health benefits in general. Taking into ac- count the likely incidence of such plan sponsor responses to the MHPA, CBO es- timated that the true aggregate increase in health plan expenditures attributable to the MHPAwould only be 0.16 percent. Combining these figures with those from an earlier CBO analysis, the Depart- 1998–3 I.R.B15January 20, 1998 ments calculate that, in dollar terms, the total annual direct impact of the MHPA would be to increase aggregate health plan expenditures by $1.16 billion, not ac- counting for plan sponsor responses to re- duce that impact. Accounting for those responses, the actual increase in annual aggregate health plan expenditures would be $464 million. It should be noted that these figures do not account for the MHPA’s increased cost exemption, its ex- emption of firms with 50 or fewer em- ployees, the incidence of managed care plans whose added cost under the MHPA would be smaller than those of managed fee for service plans, or for plans that are separately subject to state requirements equal or greater than the MHPA’s. The Departments’estimates, reported below, incorporate these adjustments. CBO also reports the Joint Committee on Taxation’s estimate that the MHPA will reduce federal revenues by $560 mil- lion over six years. CBO explains that most of the 0.16 percent increase in plan expenditures would be shifted back to employees as lower pay, thus eroding the income and payroll tax bases. On an an- nual basis, the MHPAwould increase ex- penditures for federal annuitants’health benefits by $30 million, CBO reports. Fi- nally, the MHPA’s impact on nonfederal governmental entities would amount to $50 million, while its impact on the pri- vate sector would probably exceed $100 million, according to CBO. The CBO estimates were based on a typical fee-for-service indemnity plan with customary management techniques to control expenditures, and not on plans with other types of delivery systems, such as Health Maintenance Organiza- tions (HMOs), Preferred Provider Orga- nizations (PPOs), or Point-of-Service (POS) plans. In fact, plans using differ- ent delivery systems will face different expenditure increases under the MHPA. For example, HMOs, which typically contract with health care providers at dis- counted rates and tightly manage utiliza- tion, will face smaller increases under the MHPA. Coopers & Lybrand (C&L) also esti- mated the impact of the MHPA(Ronald E. Bachman, “An Actuarial Analysis of S. 2031, The Mental Health Parity Act of 1996,” prepared for the American Psy- chological Association. Coopers & Ly- brand LLP, September 1996). C&Lesti- mated that the MHPAwould increase plan expenditures by 0.12 percent per plan on average before taking into account any re- sponses by plan sponsors. Taking plans sponsors’responses into account and using the same response assumption as CBO, C&Lestimated that plan expendi- tures would increase by less than 0.05 percent. In dollar terms, these increases would amount to $348 million and $139 million respectively. Unlike CBO, C&Lconsidered four dif- ferent delivery systems: fee-for-service with standard utilization review on typical medical services, fee-for-service with specialized mental health utilization re- view, PPO and POS plans with special- ized mental health utilization review, and HMO and carve-out mental health plans. Under each delivery system, C&Lalso considered a variety of annual dollar lim- its ranging from $10,000 to unlimited amounts, rather than assuming that all plans in the delivery system provided the same level of benefits. The Departments performed additional quantitative analysis, generally analogous to CBO’s, in the course of assessing the impact of the regulatory discretion re- flected in this rule. The additional analy- sis suggests that the direct impact of the MHPA, not accounting for plan sponsors’ responses, would be to increase annual aggregate health plans expenditures by 0.29 percent or $653 million. Under CBO’s assumption regarding plan spon- sor responses to reduce the added expen- diture, actual added expenditures would amount to $261 million. The Depart- ments did not attempt to independently quantify such responses. However, the Departments estimate that if all plans eli- gible for the one percent cost exemption exercise it, the increase in plan expendi- tures would be reduced from 0.29 percent to 0.14 percent or $310 million. The De- partments’analysis is detailed below. c.Exercise of Regulatory Discretion One Percent Cost Exemption The main area in which the agencies exercised regulatory discretion is in con- nection with the one percent cost increase exemption. Alternative regulatory inter- pretations can impact the outcome of the number of plans, firms, policyholders, and covered lives that would be exempted from the MHPA. The Departments considered options concerning the interpretation of the one- percent cost exemption and how it should be implemented. In general, they consid- ered (1) whether the eligibility for the ex- emption should be determined retrospec- tively or prospectively, and what, if any, rules should be established with respect to how eligibility should be determined, (2) whether eligibility should be contingent on affirmative approval from an enforce- ment agency or simply subject to possible review by such an agency, and (3) whether plan sponsors electing exemp- tions should be required to notify partici- pants and/or enforcement agencies of this action and/or to disclose to these parties evidence documenting eligibility for the exemption. They also considered the ad- ministrability of each option, seeking to balance the costs and benefits to plans and participants, as well as the benefits and burdens of the regulatory scheme on the federal government. Retro/prospective Determination The options considered ranged from a purely retrospective interpretation to a purely prospective one, and included in- termediate interpretations that blend these two approaches. Under a purely retrospective interpreta- tion, the one percent increased cost ex- emption would be based on actually in- curred expenditures increases, measured retrospectively after implementation of the statute. In other words, all plans must comply and provide parity of annual and/or lifetime dollar limits of mental health and medical services for the first year beginning with the start of a plan year on or after January 1, 1998. If during the first year, a plan experiences increases in expenditures equal to one percent or more as a result of complying with the statute, that plan would then be eligible to exercise an exemption from the MHPA for subsequent plan years. The calculation for determining the percent increase would be based on the ratio of the increase in plan expenditures to the total plan expenditures, that is, both medical and mental health expenditures. For self-insured plans, the numerator would be the actual value of mental health claims paid in excess of the previous plan January 20, 1998161998–3 I.R.B. limits. For example, if the annual mental health limit were $10,000 and the med- ical/surgical were $1,000,000, then the sum of all mental health claims paid in excess of $10,000 would be included in the numerator of the ratio used for that plan in calculations related to the one per- cent exemption. The denominator for self-insured plans would be the total value of medical and mental health claims ex- cluding mental health claims in excess of $10,000. If the result is an increase of one or more percent, the plan would be ex- empt from complying with the statute in any other year until the statute sunsets in 2001. Because there is a lag between the time that claims are incurred and the time they are reported, complete data needed for the calculation might not be available until three or six months after the end of the first plan year under the MHPA. With respect to fully insured plans, the calcula- tion would be slightly different. To the extent that different plans’experiences are pooled for purposes of setting premi- ums, their eligibility for the exemption would depend on their pooled experience under MHPA, rather than on each plan’s individual experience. The purely retrospective interpretation would minimize the availability of the ex- emption, and therefore might result in both the greatest incidence of parity in lifetime and annual dollar limits and the greatest incidence of other plan actions to reduce or offset the increase in expendi- tures arising from the MHPA. It would also assure that all plan elections to exer- cise the one percent increased cost ex- emption are based on actual experience under the MHPA’s parity requirements and not on projections or estimates of such experience. Under a purely prospective interpreta- tion, the a plan would be eligible for the exemption prospectively if its expected additional expenditures from the MHPA act equaled or exceeded one percent of its expected total expenditures absent the MHPA. Aself-insured plan would project these figures, relying on available data and actuarial projection methods. Afully insured plan would compare legitimate premium quotes with and without the ex- emption to determine if the difference equals or exceeds one percent. The purely prospective interpretation would maximize the availability of the exemp- tion, and therefore might result in both the least incidence of parity in lifetime and annual dollar limits and the least inci- dence of other plan actions to reduce or offset expenditure increases arising from the MHPA. Other interpretations were also consid- ered, some closer to a purely retrospective interpretation and others closer to a purely prospective one. For example, one inter- pretation might allow plans to prospec- tively determine their eligibility and exer- cise the exemption, but only based upon a narrowly constrained analysis of their own prior experience, taking into account only the potential added expenditure from the MHPAassociated with participants whose past mental health claims reached or nearly reached MHPA-prohibited dol- lar limits. Interpretations closer to the purely retrospective view would lessen the availability of the exemption, and therefore might result in both greater inci- dence of parity in lifetime and annual dol- lar limits and lesser incidence of other plan actions to reduce or offset expendi- ture increases arising from the MHPA; those closer to the purely prospective view would do the opposite. The approach adopted under this rule, referenced above, can be characterized as modified retrospective approach, based on a relatively brief base period. It is in- tended to assure the accurate measure- ment of increased costs while minimizing the burden on plan sponsors who wish to exercise the exemption as soon as accu- rate measurements can be made. It also assures that all plan elections to exercise the one percent increased cost exemption are based on actual experience under the MHPA’s parity requirements and not on projections or estimates of such experi- ence. The rule eases compliance burdens by providing a transition period under which certain plans whose plan years begin during the first quarter of 1998 can exercise the exemption until April 1, 1998. Exemption Authority This rule provides that plans may deter- mine their own eligibility for the exemp- tion and, if eligible, exercise the exemp- tion, without affirmative approval from any enforcement agency. Notification and Disclosure The Departments also exercised discre- tion in requiring notice and disclosure in connection with the one percent increased cost exemption. The rule requires plans exercising the one percent increased cost exemption during all or part of the first quarter of 1998 under the rule’s transition provisions to notify the federal govern- ment, and to post a copy of this notice at the workplace. It further requires plans otherwise exercising the exemption to no- tify participants and the federal govern- ment, and to disclose on request to these parties summary documentation of the plans’eligibility for the exemption. Notifications and disclosures will be of benefit to participants. They will help as- sure plans’compliance with the MHPA, and will promote participants’under- standing of their and their plans’status under the MHPA. Moreover, by promot- ing participants’understanding, notifica- tions and disclosures will inform partici- pants’choices among plans and their feedback to plan sponsors, thereby foster- ing more vigorous competition among plan sponsors and issuers to provide bene- fits attractive to participants at competi- tive prices. The cost of these notifications and disclosures is outlined below. Weighted Average Limits The Departments also exercised discre- tion in developing rules that specify when plans may impose separate dollar limits on mental health benefits equal to the weighted average of limits imposed on other benefit categories, and in how this weighted average may be calculated. In general, the rules provide that such mental health limits may be imposed if the benefit categories to which separate limits apply account for at least one-third of total plan expenditures and are comparable in scope to mental health benefits. The average is calculated by weighting each applicable limit to reflect its share of total plan expen- ditures. Any unlimited categories are fig- ured into the average by using in place of a limit a reasonable estimate of the maxi- mum plan expenditure that could possibly be incurred in connection with all such cat- egories, and weighting this estimate to re- flect the proportion of total plan expendi- tures attributable to all such categories. Alternative rules might have permitted more, fewer, or different plans to impose such limits on mental health benefits, and/or resulted in calculated averages that were higher or lower. For example, if un- limited categories were treated as having infinite limits, then the weighted average of category limits would equal infinity and the option of imposing a weighted av- erage limit on mental health benefits ef- fectively would be foreclosed. In con- trast, if limits applicable to benefit categories narrower in scope than mental health benefits could be averaged to ar- rive at the permissible mental health limit, plans might be able to impose very low limits on very narrow benefit categories, with little effect on coverage of these cat- egories but with the result of a lower per- missible mental health benefit limit. d. Impact of Regulatory Discretion Because the Departments exercised regulatory discretion in connection with the one percent cost exemption, it is nec- essary to quantify the number of plans eli- gible for the exemption. This requires both estimates of the affected universe and estimates of the distribution of im- pacts within that universe. CBO reported universe estimates but did not estimate the distribution of impacts. C&Lpro- vided a distribution but not universe esti- mates. Thus, neither source provides the necessary basis for estimating the reach of the one percent cost exemption. To ad- dress this gap, the Departments, assisted by Price Waterhouse LLP, combined the CBO and C&Lanalyses with other data to produce relevant national estimates, as follows. First, the Departments estimated the relevant universe at 3.0 million plans sponsored by 2.8 million employers cov- ering 145 million individuals. To derive these estimates, we tallied the number of group health plan policyholders and de- pendents by firm size from the Census Bureau’s March 1996 Current Population Survey. Census enterprise data provided average firm sizes in each size category, allowing us to estimate the number of em- ployers covering these individuals. KPMG Peat Marwick’s 1997 survey pro- vided the average number of plans per firm in each size group, supporting esti- mates of the number of plans. Data from the Bureau of Labor Statistics’Employee Benefits Survey and the Health and Re- tirement Study provided a proportionate breakdown of plans and individuals in each firm size group across plan types (HMO, PPO, and fee for service). Like- wise, data from KPMG and Foster Hig- gins surveys were used to divide insured from self-insured plans. Second, the Departments narrowed the focus to plans affected by the MHPA. Approximately 296,000 plans, sponsored by 136,000 employers and covering 113 million individuals, would be directly af- fected by the MHPA. This excludes firms with fewer than 50 employees (which are exempt under ERISASection 712 (c)(1)), plans already covered by state mandates to provide parity in annual and lifetime dollar limits (based on C&Land Hay Huggins reports of the incidence of differ- ential limits—roughly 29,000 plans were excluded here), and insured plans in 13 states that, independent of the MHPA, as of January 1, 1998 will require parity equivalent to or surpassing that required by the MHPA. (Those 13 states are: Indi- ana, Maryland, Minnesota, Montana, Arkansas, Colorado, Connecticut, Maine, Missouri, New Hampshire, North Car- olina, Rhode Island, and Texas.). Some of the plans identified here as affected may not be affected. The MHPApermits self-insured nonfederal governmental plans to opt out of compliance. This in- cludes roughly 22,000 plans covering about 18 million individuals. It also ex- empts plans whose costs increase by one percent or more, as enumerated below. Third, the Departments estimated the overall impact of the MHPAas follows: affected plans’potential increases in men- tal health expenditures under the MHPA equal $653 million, or 0.29 percent of af- fected plans’$226 billion in total expen- ditures. (The 0.29 percent figure is benchmarked to CBO’s estimate that the average cost increase for indemnity plans would be 0.4 percent, but it is adjusted to reflect C&L’s assessment of the relative magnitude of cost increases for different plan types. The $226 billion figure is benchmarked to CBO’s $290 billion uni- verse, but reduced proportionately to re- flect the Department’s estimate of the pro- portion of the total universe that is affected by the MHPA.) Under CBO’s as- sumption regarding plan sponsor actions to reduce the added expenditure, actual added expenditures would amount to $261 million. Expenditures could be smaller still as a result of self-insured nonfederal governmental plans’right to opt out of compliance and the MHPA’s one percent increased cost exemption, which are not accounted for in the forego- ing estimates. Recall also that these ex- penditures represent transfer payments and not social costs. One Percent Cost Exemption The effect of this rule will be to pro- hibit all covered plans from imposing an- nual or lifetime dollar limits on mental health benefits that are lower than limits imposed on medical and surgical benefits during at least seven months of the first plan year beginning on or after January 1, 1998. Specifically, after six months, the rule permits plans to exercise an exemp- tion as soon as they document a cost in- crease of one percent or more and provide 30 days notice to participants and the fed- eral government. Exactly when a given plan will become eligible to elect the one percent increased cost exemption will depend on the timing of its increased costs and its documenta- tion of those costs. In many cases, plans’ increased costs under the MHPAwill not equal or exceed one percent until more than the initial six months have elapsed. For example, added costs from the MHPA’s provision restricting the use of annual dollar limits on mental health ben- efits would likely be concentrated late in the plans year, when some participants would otherwise have reached these lim- its. In addition, plans that utilize this rule’ transition period may not be affected by the MHPA’s provisions until after the first three months of the plan year have elapsed. Therefore, these may be less likely to incur added costs of one percent or more until later in the plan year, or until a subsequent plan year (in which they would be affected by the MHPAbe- ginning on the first day of the plan year). Whether eligible plans wishing to re- duce the direct impact of the MHPAwill opt to pursue the exemption or opt for al- ternative responses will depend on each plan’s particular circumstances and priori- ties. The Departments estimated the number of affected plans with potential increases of at least one percent. Roughly 30,000 1998–3 I.R.B17January 20, 1998 plans, or about 10 percent of a plans af- fected by MHPA, potentially would be el- igible for the one-percent increased cost exemption. That is, all else being equal, complying with the MHPAwould in- crease 30,000 plans’expenditures by at least one percent. These plans cover about 5 million policyholders and 11 mil- lion individuals. This is the universe po- tentially affected by the provisions of this rule that address the one percent increased cost exemption. In assessing the impact of this rule, the Departments considered the economic consequences of its provisions imple- menting the one percent cost exemption. Several factors are likely to affect the magnitude of those consequences. First, under any interpretation, only 10 percent of MHPA-affected plans (or 30,000 plans) could become eligible for the exemption, and only some of those would elect to exercise it. The estimated 30,000 plans that would could become el- igible for the one-percent cost exemption represents the upper limit of the number of plans that would actually exercise the exemption. Many of the potentially eligi- ble plans are likely to forego the exemp- tion in favor of other permitted actions. A survey of 300 large firms conducted by William M. Mercer, Inc., found that fewer than 2 percent intended to pursue the one percent increased cost exemption. Ex- trapolated to the Departments’estimated plan universe, this suggests that 6,000 plans, or 22 percent of the 30,000 that are potentially eligible, would pursue the ex- emption. Second, expenditure increases from the MHPAwill generally be modest, even for plans potentially eligible for the one per- cent cost exemption. Their potential ex- penditure increase would be $332 million on a base of $23 billion in total expendi- tures, or 1.47 percent overall. Third, as noted above, plans can be de- signed in ways that lessen these expendi- ture increases. Fourth, the 2,215 self-insured nonfed- eral governmental plans that might be- come eligible for the one percent cost ex- emption are separately permitted to opt out of the MHPAentirely, thereby exer- cising an alternative exemption with equivalent effect. These plans cover 1.8 million individuals, or 16 percent of indi- viduals in potentially eligible plans. Fifth, the estimates presented in this analysis are conservative; actual expendi- tures arising from compliance with the MHPAare likely to be less than reported here. In particular, the estimates may un- derstate the reach and cost-effectiveness of managed mental health programs that will exist during the years that the MHPA is in effect (See Roland Sturm, “How Ex- pensive is Unlimited Mental Health Care Coverage Under Managed Care?” JAMA, Nov. 12, 1997—Vol. 278 No. 18). Sixth, because plan expenditure in- creases under the MHPA(aside from in- creases in administrative expenses) are transfers, the availability and use of the exemption does not change aggregate so- cial welfare. However, the availability and use of the exemption does affect the size and incidence of transfers across af- fected parties. Finally, this rule preserves the availabil- ity of most of this savings under the one percent exemption—certain eligible plans are permitted to exercise the exemption after seven months, thereby operating under the exemption for up to 38 of the 45 months during which the MHPAis in ef- fect. This rule also requires certain notices and disclosures by plans exercising the one percent increased cost exemption. The Departments undertook to estimate the paperwork burdens associated with these provisions, as well as the burden as- sociated with determining whether a plan is eligible for the exemption. These esti- mates are summarized below. The estimates reported immediately below are for all plans affected by the no- tice and disclosure provisions of this rule. The Paperwork Reduction Act (PRA) analysis that follows is presented sepa- rately for affected private-sector plans and for plans sponsored by nonfederal governmental employers, which are under the jurisdictions of the Departments of Labor and of Health and Human Services, respectively. With respect to the notice to partici- pants and beneficiaries and to the federal government by plans exercising the one percent cost exemption, the maximum possible number of such notices is ap- proximately 5.0 million (reflecting all plans potentially eligible to elect the ex- emption), while a more likely figure is 1.1 million (reflecting the Mercer survey cited above). Assuming each notice re- quires 2 minutes of labor at $11 per hour, plus $0.50 for postage and materials, total costs would amount to up to $4.3 million or more probably $931,000. (These as- sumptions reflect plans’ability to satisfy this notice requirement through the provi- sions of a separately required summary of material modifications, as well as avail- ability of a model notice to the govern- ment, which together essentially elimi- nate separate preparation burdens under this requirement and help minimize ongo- ing burdens.) With respect to requirement for group health plans to notify the federal govern- ment of use of the transition period, and to post these notices in the workplace, only those plans whose plan years begin during the first three months on 1998 and who are potentially eligible for the one percent cost exemption are potentially af- fected by this provision. These notices would be filed and posted within 30 days or less of the beginning of the plan year, so all would be filed in 1998. Based on annual reports filed with the Department of Labor, the Departments estimate that 60 percent of all eligible plans, accounting for 72 percent of participants in such plans, begin their plan years during these months. This amounts to 18,000 plans, representing the maximum number of no- tices that would be filed. Extrapolating from the Mercer survey cited above, about 4,000 of these plans might intend to pur- sue the exemption, representing a more probable number of notices to be filed. Applying the same per unit cost assump- tions as above to the filing and posting of these notices, the cost of these notices would be no more than $8,000 and more likely $2,000. These assumptions reflect the availability of a model notice, the use of which eliminates preparation costs and helps minimize ongoing burdens. With respect to the requirement for plans to disclose on request summary in- formation documenting the plan’s eligibil- ity for the one percent increased cost ex- emption, the number of such disclosures will depend on the volume of requests. One might expect requests to arise most commonly when participants are at or near plans’dollar limits. Hay Huggins esti- mates for the Congressional Research Ser- vice (See Roland Sturm, “How Expensive is Unlimited Mental Health Care Coverage January 20, 1998181998–3 I.R.B. Under Managed Care?” JAMA, Nov. 12, 1997—Vol. 278 No. 18) suggest that 0.73 percent of participants on average incur mental health claims of more than $10,000—a typical annual limit—in a given year. The Departments adjusted this figure to reflect the estimated relationship between increased expenditures under the MHPAfor plans eligible for the one per- cent increased cost exemption and in- creased expenditures under the MHPAfor all affected plans, concluding that 3.74 percent of participants in plans eligible for the one percent increased cost exemption incur claims of more than $10,000 in a given year. Assuming that this proportion of participants in plans electing the ex- emption request disclosures, the maxi- mum number of such disclosure requests would be 186,000, while a more probable figure would be 40,000. Given the same per unit cost assumptions as above, the as- sociated costs would be $161,000 and $35,000, respectively. Finally, with respect to plan determina- tions of eligibility for the one percent in- creased cost exemption, the Departments expect that plans wishing to exercise the one percent increased cost exemption or their service providers will revise their automated claim record systems to facili- tate calculation of the plans’increased costs attributable to the MHPA. The number of plans performing such func- tions in-house that might wish to exercise the exemption is estimated to be no than 5,346 and more probably 1,142. The number of service providers (including health insurance issuers and third party administrators) that will perform this function for plans that wish to exercise the exemption is estimated to be 1,770 (including 400 third party administrators, 650 health insurers, 645 HMOs, and 75 Blue Cross Blue Shield organizations). Assuming a start up cost of $5,000 per af- fected entity, the total start-up cost associ- ated with determining plans’eligibility to exercise the exemption amounts to $14.6 million to $35.6 million, to be amortized over 10 years beginning in 1998. The estimates of the numbers and costs of notices, disclosures and calculations reported above, and below in connection with the Paperwork Reduction Act, may be high with respect to nonfederal gov- ernmental plans. An estimated 2,215 self- insured nonfederal governmental plans might become eligible for the one percent cost exemption. These plans are sepa- rately permitted to opt out of the MHPA entirely, thereby exercising an alternative exemption with equivalent effect, and without becoming subject to the calcula- tion, notice, and disclosure requirements. These plans cover 1.8 million individuals, or 16 percent of individuals in potentially eligible plans. Weighted Average The economic impact of the Depart- ments’exercise of discretion in the weighted average rule is also expected to be modest. First, separate limits for benefit cate- gories other than mental health are not very common. For example, among full- time employees at establishments with 100 or more employees participating in non-HMO group health plans in 1993, only a fraction were subject to separate limits for many major benefit categories. For example, just 14 percent were subject to separate limits for inpatient surgery, just 13 percent were subject to such limits for outpatient surgery, and only about one in four were subject to separate limits for both inpatient and office physician visits (U.S. Bureau of Labor Statistics, Em- ployee Benefits in Medium and Large Pri- vate Establishments, 1993). “Separate limits” in this context include not only dollar limits, but also non-dollar limits, such as inpatient day or outpatient visit limits, as well as differential coinsurance rates, copayments, or deductibles. There- fore, the proportion with separate dollar limits that would permit imposition of a weighted average limit on mental health benefits would be even smaller. In addi- tion, such separate limits are even less common in HMOs. Second, discretion exercised in the weighted average rule affects plans’abil- ity to impose weighted average limits on mental health benefits only at the margin. In other words, compared with the ap- proach set forth in the rule, alternative ap- proaches would have increased or de- creased the proportion of plans that are able to impose weighted average limits and the dollar level of calculated averages by only a small amount. Third, not all plans that are permitted to impose weighted average limits on mental health benefits will elect to do so. Fourth, some plans that under the rule are not permitted to impose weighted av- erage limits on mental health benefits, under an alternative approach, might have been permitted to impose only a relatively high limit. As such, their expenditure in- creases from the MHPAmight have been nearly the same with a weighted average limit on mental health benefits as with no separate limit on such benefits. Consider a plan with a $500,000 annual cap on all inpatient care and a $250,000 annual cap on all outpatient care, and a $25,000 an- nual cap on mental health benefits. Under the interim rules, such a plan could not impose a weighted average limit on men- tal health benefits. Any separate limit on mental health care would have to be at least $750,000, or at least $500,000 for inpatient care and at least $250,000 for outpatient care. Had the plan been per- mitted to impose a weighted average cap, however, it still would have been required to increase its mental health cap from $25,000 to some amount between $250,000 and $500,000, depending on the weights. Finally, as with the one percent cost ex- emption and with the MHPAgenerally, the impact of regulatory discretion in the weighted average rule will be reduced be- cause self-insured nonfederal governmen- tal plans can opt out, the MHPA’s added expenditure is modest, plans can be de- signed in ways that lessen the MHPA’s added expenditure, and the estimates pre- sented here are conservative. F. Unfunded Mandates Reform Act of 1995 The Unfunded Mandates Reform Act of 1995 (P.L. 104–4) requires agencies to prepare several analytic statements before proposing any rules that may result in an- nual expenditures of $100 million by state, local and tribal governments or the private sector. These rules are not subject to the Unfunded Mandates Reform Act because they are interim final rules. However, consistent with the policy em- bodied in the Unfunded Mandates Reform Act, the regulation has been designed to be the least burdensome alternative for 1998–3 I.R.B19January 20, 1998 January 20, 1998201998–3 I.R.B. state, local and tribal governments, and the private sector, while achieving the ob- jectives of the MHPA. G. Small Business Regulatory Enforcement and Fairness Act of 1995. The Administrator of the Office of In- formation and Regulatory Affairs of the Office of Management and Budget has determined that this is a major rule for purposes of the Small Business Regula- tory Enforcement Fairness Act of 1996 (5 U.S.C. Section 801 et. seq.)(SBREFA). The Secretaries have determined that the effective date of these interim final rules is January 1, 1998. Pursuant to Section 808(2) of SBREFA, the Secretaries find, for good cause, that notice and public pro- cedure thereon are impracticable, unneces- sary and contrary to the public interest. These rules are adopted on an interim final basis because the Secretaries have determined that without prompt guidance some members of the regulated commu- nity may have difficulty complying with the MHPArequirements, which may re- sult in an adverse impact on participants and beneficiaries with regard to their mental health benefits under group health plans and the protections provided under MHPA. Moreover, MHPA’s requirements will affect the regulated community in the immediate future. MHPA’s requirements are effective for all group health plans, and for health in- surance issuers offering coverage in con- nection with such plans for plan years be- ginning on or after January 1, 1998. Plan administrators and sponsors, issuers and participants and beneficiaries will need guidance on the new statutory provisions before MHPA’s effective date. As noted earlier, these interim rules take into ac- count comments received by the Depart- ments, in response to the request for pub- lic comments on MHPApublished in the Federal Registeron June 26, 1997 (62 FR 34604). For the foregoing reasons, the Departments find that notice and public comment would be impracticable, unnec- essary and contrary to the public interest. H. Paperwork Reduction Act—The Department of Laborand the Department of the Treasury The Department of Labor and the De- partment of the Treasury have submitted this emergency processing public infor- mation collection request (ICR), consist- ing of three distinct ICRs to the Office of Management and Budget (OMB) for re- view and clearance under the Paperwork Reduction Act of 1995 (Pub. L. 104–13, 44 U.S.C. Chapter 35). The Departments have asked for OMB clearance as soon as possible, and OMB approval is antici- pated by the applicable effective date. These regulations contain three dis- tinct ICRs. The first ICR is a notice to participants and beneficiaries and to the federal government of the plan’s election of the exemption from the MHPA’s provi- sions due to an increase in cost under the plan of at least one percent attributable to compliance with these provisions. Aplan may satisfy this requirement by provid- ing participants and beneficiaries with a notice of material reductions in covered service or benefits, under the Department of Labor’s regulations at 29 CFR section 2520.104b– 3(d), that includes the infor- mation in paragraph (f)(3)(i) of this in- terim final rule regarding issuing a notice to participants and beneficiaries of the plan’s exemption from these parity re- quirements. Before the one percent in- creased cost exemption is effective, the plan must also notify the federal govern- ment. For this purpose, the group health plan may either send the Department of Labor a copy of the summary of material reductions in covered services or benefits sent to participants and beneficiaries, containing the plan number and the plan sponsor’s employer identification num- ber, or the plan (or coverage) may use the Departments’model notice in this interim final rule which has been developed for this purpose. The second ICR is a summary of the in- formation used to calculate the plan’s in- creased costs under the MHPAfor pur- poses of electing the one percent increased cost exemption, which the plan must make available to participants and beneficiaries, on request at no charge. The third ICR is a notice of a group health plan’s use of the transition period. The rule requires plans exercising the one percent increased cost exemption during all or part of the first quarter of 1998 under the rule’s transition provisions to notify the federal government, and to post a copy of this notice at the workplace. 1.Notice to Participants and Beneficiaries and the Federal Government of Electing One Percent Increased Cost Exemption i.Department of Labor The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a preclear- ance consultation program to provide the general public and Federal agencies with an opportunity to comment on proposed and/or continuing collections of informa- tion in accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104–13, 44 U.S.C. Chapter 35) and 5 CFR 1320.11. This program helps to ensure that requested data can be provided in the desired format, reporting burden (time and financial resources) is minimized, collection instruments are clearly under- stood, and the impact of collection re- quirements on respondents can be prop- erly assessed. Currently, the Pension and Welfare Benefits Administration is solic- iting comments concerning the proposed collection of information, Notice to Par- ticipants and Beneficiaries and the Fed- eral Government of Electing One Percent Increased Cost Exemption. Acopy of the proposed ICR can be obtained by contact- ing the employee listed below in the con- tact section of the notice. Information collection: affected parties are not required to comply with the ICRs in these rules until the Department of Labor publishes in the Federal Register the control numbers assigned to these ICRs by OMB. The publication of the control numbers notifies the public that OMB has approved these ICRs under the Paperwork Reduction Act of 1995. The Department has asked for OMB clearance as soon as possible, and OMB approval is anticipated by the applicable effective date. Dates:Written comments must be sub- mitted to the office listed in the addressee section below on or before February 20, 1998. The Department of Labor is partic- ularly interested in comments which: •evaluate whether the proposed collec- tion of information is necessary for the proper performance of the functions of the agency, including whether the infor- mation will have practical utility; 1998–3 I.R.B21January 20, 1998 •evaluate the accuracy of the agency’s estimate of the burden of the proposed collection of information, including the validity of the methodology and as- sumptions used; •enhance the quality, utility, and clarity of the information to be collected; and •minimize the burden of the collection of information on those who are to re- spond, including through the use of ap- propriate automated, electronic, me- chanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submissions of responses. Addressee: Gerald B. Lindrew, Office of Policy and Research, U.S. Department of Labor, Pension and Welfare Benefits Administration, 200 Constitution Av- enue, Room N-5647, Washington, DC 20210. Telephone: 202-219-4782 (this is not a toll-free number). Fax: 202-219- 4745. ii.Department of the Treasury The collection of information is in 54.9812–1T. This information is required by the interim final rules so that partici- pants will be informed about their rights under MHPA, and so that participants and beneficiaries, and the federal government, will receive notice of a plan’s election of the one percent increased cost exemption. The likely respondents are business or other for-profit institutions, non-profit insti- tutions, small businesses or organizations, and Taft-Hartley trusts. Responses to this collection of information are required to obtain the benefit of the exemption. Books or records relating to a collec- tion of information must be retained as long as their contents may become mater- ial in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103. Comments on the collection of infor- mation should be sent to the Office of Management and Budget, Attn: Desk Of- ficer for the Department of the Treasury, Office of Information and Regulatory Af- fairs, Washington, DC 20503, with copies to the Internal Revenue Service, Attn: IRS Reports Clearance Officer, T:FP, Wash- ington, DC 20224. Comments on the col- lection of information should be received on or before February 20, 1998. In light of the request for OMB clearance by the effective date of the MHPA, submission of comments within the first 30 days is encouraged to ensure their consideration. Comments are specifically requested con- cerning: Whether the proposed collection of in- formation is necessary for the proper per- formance of the functions of the Internal Revenue Service, including whether the information will have practical utility; The accuracy of the estimated burden associated with the proposed collection of information; How to enhance the quality, utility, and clarity of the information to be collected; How to minimize the burden of com- plying with the proposed collection of in- formation, including the application of automated collection techniques or other forms of information technology; and Estimates of capital or start up costs and costs of operation, maintenance, and pur- chase of services to provide information. I.Background:MHPAgenerally re- quires that group health plans provide par- ity in the application of dollar limits to mental health and medical/surgical bene- fits. The statute exempts plans from this requirement if its application results in an increase in the cost under the plan or cov- erage of at least one percent. This regula- tion requires a plan electing this exemption to notify participants and beneficiaries and the federal government of the plan’s elec- tion of the exemption. This ICR covers this notification requirement. II.Current Actions: Under 29 CFR 2590.712 (f)(3)(i) and (ii), and 26 CFR 54.9812–1Ta group health plan electing the one percent exemption is obligated to provide a written notice of that election to participants and beneficiaries and to the federal government of the plan’s election of the exemption. Aplan may satisfy this requirement by providing participants and beneficiaries with a notice of material re- ductions in covered service or benefits, under the Department of Labor’s regula- tions at 29 CFR section 2520.104b–3(d), that includes the information in paragraph (f)(3)(i) of this interim final rule regard- ing issuing a notice to participants and beneficiaries of the plan’s exemption from these parity requirements. To satisfy the requirement to notify the federal gov- ernment, a group health plan may either send the Department a copy of the sum- mary of material reductions in covered services or benefits sent to participants and beneficiaries, containing the plan number and the plan sponsor’s employer identification number, or the plan may use the Department’s model notice in this in- terim final rule which has been developed for this purpose. Based on past experi- ence, the staff believes that most of the materials required to be issued under this notice procedure will be prepared by con- tract service providers such as insurance companies and third-party administrators. Type of Review: New. Agencies: U.S. Department of Labor, Pension and Welfare Benefits Administra- tion; U.S. Department of the Treasury, In- ternal Revenue Service. Title: Notice to Participants and Bene- ficiaries and the Federal Government of Electing One Percent Increased Cost Ex- emption OMB Number: XXXXXXX Affected Public: Individuals or house- holds; Business or other for-profit; Not- for-profit institutions; Group health plans. Frequency: On occasion Burden: YearTotal Total ResponsesAverage TimeBurden HoursCost Respondents (range)per Response(range)(range) (range)(range) 1998––––– 19995,612 to 25,446813,505 to 3.8MM2 minutes6,324 to 29,605$705,037 to $3.3MM 2000 ––––– TOTALS5,612 to 25,446813,505 to 3.8MM2 minutes6,324 to 29,605$705,037 to $3.3MM Comments submitted in response to this notice will be summarized and/or in- cluded in the request for OMB approval of the ICRs; they will also become a mat- ter of public record. 2.Calculation and Disclosure of Documentation of Eligibility for Exemption i.Department of Labor The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a preclear- ance consultation program to provide the general public and Federal agencies with an opportunity to comment on proposed and/or continuing collections of informa- tion in accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104–13, 44 U.S.C. Chapter 35) and 5 CFR 1320.11. This program helps to ensure that requested data can be provided in the desired format, reporting burden (time and financial resources) is minimized, collection instruments are clearly under- stood, and the impact of collection re- quirements on respondents can be prop- erly assessed. Currently, the Pension and Welfare Benefits Administration is solic- iting comments concerning the proposed collection of information, Disclosure of Documentation of Eligibility for Exemp- tion. Acopy of the proposed ICR can be obtained by contacting the employee listed below in the contact section of the notice. Information collection: affected parties are not required to comply with the ICRs in these rules until the Department of Labor publishes in the Federal Register the control numbers assigned to these ICRs by OMB. The publication of the control numbers notifies the public that OMB has approved these ICRs under the Paperwork Reduction Act of 1995. The Department has asked for OMB clearance as soon as possible, and OMB approval is anticipated by the applicable effective date. Dates:Written comments must be sub- mitted to the office listed in the addressee section below on or before February 20, 1998. The Department of Labor is partic- ularly interested in comments which: •evaluate whether the proposed collec- tion of information is necessary for the proper performance of the functions of the agency, including whether the infor- mation will have practical utility; •evaluate the accuracy of the agency’s estimate of the burden of the proposed collection of information, including the validity of the methodology and as- sumptions used; •enhance the quality, utility, and clarity of the information to be collected; and •minimize the burden of the collection of information on those who are to re- spond, including through the use of ap- propriate automated, electronic, me- chanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submissions of responses. Addressee: Gerald B. Lindrew, Office of Policy and Research, U.S. Department of Labor, Pension and Welfare Benefits Administration, 200 Constitution Avenue, Room N-5647, Washington, DC 20210. Telephone: 202-219-4782 (this is not a toll-free number). Fax: 202-219-4745. ii.Department of the Treasury The collection of information is in Sec- tion 54.9812–1T. This information is re- quired by the interim final rules so that participants will be informed about their rights under MHPA, and so that partici- pants and beneficiaries may receive a summary of the information upon which the plan based it election of the one per- cent increased cost exemption. The likely respondents are business or other for- profit institutions, non-profit institutions, small businesses or organizations, and Taft-Hartley trusts. Responses to this col- lection of information are required to ob- tain the benefit of the exemption. Books or records relating to a collec- tion of information must be retained as long as their contents may become mater- ial in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103. Comments on the collection of infor- mation should be sent to the Office of Management and Budget, Attn: Desk Of- ficer for the Department of the Treasury, Office of Information and Regulatory Af- fairs, Washington, DC 20503, with copies to the Internal Revenue Service, Attn: IRS Reports Clearance Officer, T:FP, Wash- ington, DC 20224. Comments on the col- lection of information should be received on or before February 20, 1998. In light of the request for OMB clearance by the effective date of the MHPA, submission of comments within the first 30 days is encouraged to ensure their consideration. Comments are specifically requested con- cerning: Whether the proposed collection of in- formation is necessary for the proper per- formance of the functions of the Internal Revenue Service, including whether the information will have practical utility; The accuracy of the estimated burden associated with the proposed collection of information; How to enhance the quality, utility, and clarity of the information to be collected; How to minimize the burden of com- plying with the proposed collection of in- formation, including the application of automated collection techniques or other forms of information technology; and Estimates of capital or start up costs and costs of operation, maintenance, and pur- chase of services to provide information. I.Background:MHPAgenerally re- quires that group health plans provide parity in the application of dollar limits to mental health and medical/surgical bene- fits. The statute exempts plans from this requirement if its application results in an increase in the cost under the plan or cov- erage of at least one percent. This regula- tion requires plans wishing to elect this exemption to calculate their increased costs according to certain rules. It further requires plans electing this exemption to disclose to participants and beneficiaries (or their representatives), on request, and at no charge, a summary of the informa- tion upon which the exemption was based. This ICR covers this disclosure re- quirement. II.Current Actions: Under 29 CFR 2590.712(f)(2) and 26 CFR 54.9812–1T, a group health plan wishing to elect the one percent exemption must calculate their increased costs according to certain rules. Under 29 CFR 2590.712(f)(4) and 26 CFR 54.9812–1T, a group health plan electing the one percent exemption is ob- ligated to disclose to participants and ben- eficiaries (or their representatives), on re- quest and at no charge, a summary of the information on which the exemption was based. January 20, 1998221998–3 I.R.B. Type of Review: New. Agencies: U.S. Department of Labor, Pension and Welfare Benefits Administra- tion; U.S. Department of the Treasury, In- ternal Revenue Service. Title: Calculation and Disclosure of Documentation of Eligibility for Exemp- tion OMB Number: XXXXXXX Affected Public: Individuals or house- holds; Business or other for-profit; Not- for-profit institutions; Group Health Plans. Frequency: On occasion Calculation burden: It is expected that plans wishing to exercise the one percent increased cost exemption or their service providers will revise their automated claim record systems to facilitate calcula- tion of the plans’increased costs attribut- able to the MHPA. The number of plans performing such functions in-house that might wish to exercise the exemption is estimated to be no than 4,489 and more probably 958. The number of service providers (including health insurance is- suers and third party administrators) that will perform this function for plans using service providers that wish to exercise the exemption is estimated to be 1,770. As- suming a cost of $5,000 per affected en- tity, the total cost associated with deter- mining plans’eligibility to exercise the exemption amounts to $12.5 million to $30.1 million, to be amortized over 10 years beginning in 1998. Disclosure burden: In addition to the calculation burden, plans wishing to elect the one percent increased cost exemption will incur a burden in connection with disclosure requests from participants, as detailed below. 1998–3 I.R.B23January 20, 1998 YearTotal Total ResponsesAverage Burden HoursCost Respondents(range)Time per(range)(range) (range)Response 1998––––– 19995,612 to 25,46630,188 to 140,4122 minutes235 to 1,101$26,163 to $121,690 2000 5,612 to 25,46630,188 to 140,4122 minutes235 to 1,101$26,163 to $121,690 TOTALS5,612 to 25,46660,377 to 280,8242 minutes470 to 2,201$52,326 to $243,381 Comments submitted in response to this notice will be summarized and/or in- cluded in the request for OMB approval of the ICRs; they will also become a mat- ter of public record. 3.Notice of Group Health Plan’s Use of Transition Period, and Posting Thereof i.Department of Labor The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a preclear- ance consultation program to provide the general public and Federal agencies with an opportunity to comment on proposed and/or continuing collections of informa- tion in accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104–13, 44 U.S.C. Chapter 35) and 5 CFR 1320.11. This program helps to ensure that requested data can be provided in the desired format, reporting burden (time and financial resources) is minimized, collection instruments are clearly under- stood, and the impact of collection re- quirements on respondents can be prop- erly assessed. Currently, the Pension and Welfare Benefits Administration is solic- iting comments concerning the proposed collection of information, Notice of Group Health Plan’s Use of Transition Pe- riod. Acopy of the proposed ICR can be obtained by contacting the employee listed below in the contact section of the notice. Information collection: affected parties are not required to comply with the ICRs in these rules until the Department of Labor publishes in the Federal Register the control numbers assigned to these ICRs by OMB. The publication of the control numbers notifies the public that OMB has approved these ICRs under the Paperwork Reduction Act of 1995. The Department has asked for OMB clearance as soon as possible, and OMB approval is anticipated by the applicable effective date. Dates:Written comments must be sub- mitted to the office listed in the addressee section below on or before February 20, 1998. The Department of Labor is partic- ularly interested in comments which: •evaluate whether the proposed collec- tion of information is necessary for the proper performance of the functions of the agency, including whether the infor- mation will have practical utility; •evaluate the accuracy of the agency’s estimate of the burden of the proposed collection of information, including the validity of the methodology and as- sumptions used; •enhance the quality, utility, and clarity of the information to be collected; and •minimize the burden of the collection of information on those who are to re- spond, including through the use of ap- propriate automated, electronic, me- chanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submissions of responses. Addressee: Gerald B. Lindrew, Office of Policy and Research, U.S. Department of Labor, Pension and Welfare Benefits Administration, 200 Constitution Av- enue, Room N-5647, Washington, DC 20210. Telephone: 202-219-4782 (this is not a toll-free number). Fax: 202-219- 4745. ii.Department of the Treasury The collection of information is in Sec- tion 54.9812–1T. This information is re- quired by the interim final rules so that participants will be informed about their rights under MHPA, and so that plans electing the one percent increased cost ex- emption during all or part of the first quar- ter of 1998 under the rules’transition pro- visions will notify the federal government and post the notice in the workplace. The likely respondents are business or other for-profit institutions, non-profit institu- tions, small businesses or organizations, and Taft-Hartley trusts. Responses to this collection of information are required to obtain the benefit of the exemption. Books or records relating to a collec- tion of information must be retained as long as their contents may become mater- ial in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103. Comments on the collection of informa- tion should be sent to the Office of Man- agement and Budget, Attn: Desk Officer for the Department of the Treasury, Office of Information and Regulatory Affairs, Washington, DC 20503, with copies to the Internal Revenue Service, Attn: IRS Re- ports Clearance Officer, T:FP, Washing- ton, DC 20224. Comments on the collec- tion of information should be received on or before February 20, 1998. In light of the request for OMB clearance by the ef- fective date of the MHPA, submission of comments within the first 30 days is en- couraged to ensure their consideration. Comments are specifically requested con- cerning: Whether the proposed collection of in- formation is necessary for the proper per- formance of the functions of the Internal Revenue Service, including whether the information will have practical utility; The accuracy of the estimated burden associated with the proposed collection of information; How to enhance the quality, utility, and clarity of the information to be collected; How to minimize the burden of com- plying with the proposed collection of in- formation, including the application of automated collection techniques or other forms of information technology; and Estimates of capital or start up costs and costs of operation, maintenance, and purchase of services to provide informa- tion. I.Background:MHPAgenerally re- quires that group health plans provide parity in the application of dollar limits to mental health and medical/surgical bene- fits. The statute exempts plans from this requirement if its application results in an increase in the cost under the plan or cov- erage of at least one percent. This regula- tion requires a notice of group health plan’s use of transition period, under which plans electing the one percent in- creased cost exemption during all or part of the first quarter of 1998 under the rule’s transition provisions must notify the federal government and to post a copy of the notice in the workplace. This ICR covers this notification requirement. II.Current Actions: Under 29 CFR 2590.712(h)(3)(ii) and 26 CFR 54.9812– 1T, group health plans electing the one percent increased cost exemption during all or part of the first quarter of 1998 under the rule’s transition provisions must notify the federal government. Based on past experience, the staff believes that most of the materials required to be issued under this notice procedure will be pre- pared by contract service providers such as insurance companies and third-party administrators. Type of Review: New. Agencies : U.S. Department of Labor, Pension and Welfare Benefits Administra- tion; U.S. Department of the Treasury, In- ternal Revenue Service. Title: Notice of Group Health Plan’s Use of Transition Period OMB Number: XXXXXXX Affected Public: Individuals or house- holds; Business or other for-profit; Not- for-profit institutions; Group Health Plans. Frequency: On occasion Burden: January 20, 1998241998–3 I.R.B. YearTotal Total ResponsesAverageBurden HoursCost Respondents(range)Time per(range)(range) (range)Response 19983,348 to 15,1933,348 to 15,1932 minutes19 to 89$1,514 to $6,910 1999––––– 2000 ––––– TOTALS3,348 to 15,1933,348 to 15,1932 minutes19 to 89$1,514 to $6,910 Comments submitted in response to this notice will be summarized and/or in- cluded in the request for OMB approval of the ICRs; they will also become a mat- ter of public record. I. Paperwork Reduction Act— Department of Health and Human Services Under the Paperwork Reduction Act of 1995 (PRA), agencies are required to pro- vide a 60-day notice in the Federal Reg- isterand solicit public comment before a collection of information requirement is submitted to the Office of Management and Budget (OMB) for review and ap- proval. In order to fairly evaluate whether an information collection should be approved by OMB, section 3506(c)(2)(A) of the PRArequires that we solicit comment on the following is- sues: •Whether the information collection is necessary and useful to carry out the proper functions of the agency; •The accuracy of the agency’s esti- mate of the information collection burden; •The quality, utility, and clarity of the information to be collected; and •Recommendations to minimize the information collection burden on the affected public, including automated collection techniques. Therefore, we are soliciting public com- ment on each of these issues for the infor- mation collection requirements discussed below. Section 146.136 of this document con- tains three distinct information collection requirements, as summarized below: Type of Information Request:New collec- tion. Title of Information Collection:Mental Health Parity Act of 1996; Information Collection Requirements Contained in 45 CFR 146.136; HCFA-2891-IFC. Form Number:HCFA-R-223 (OMB ap- proval #: 0938-XXXX) Use:The information collection require- ments contained in this interim final rule will help ensure that sponsors and admin- istrators of group health plans notify the required individuals/entities of a plan’s exemption from the MHPAparity require- ments and make the data used to calculate the exemption available to affected indi- viduals and entities. Frequency:On occasion. Affected Public:States, businesses or other for profit, not-for-profit institutions, Federal Government, individuals or households. Notification Requirements:Nonfederal governmental plans, not exempt from the parity requirements by reason of an opt out under regulations at 45 CFR 146.180, must furnish participants and beneficia- ries with a notice of the plan’s exemption from the parity requirements based on in- creased costs. Aplan may satisfy this re- quirement by providing participants and beneficiaries with a notice of material re- ductions in covered services or benefits, under 29 CFR 2520.104b–3(d), that in- cludes the information in paragraph (f)(3)(i). Even though a plan generally is not required to furnish a material reduc- tion in covered services or benefits for 60 days, in no case will the exemption be ef- fective until 30 days after the notice is sent to participants and beneficiaries. For this purpose, a plan that does not furnish the summary of material reductions in covered services or benefits may satisfy its notice requirements by using the model exemption notice described above in this preamble. In addition, the nonfederal governmen- tal plan (or issuer providing coverage to such a plan) must also furnish to the De- partment of Health and Human Services a notice similar to the notice sent to partici- pants and beneficiaries before the exemp- tion is effective. For this purpose, the plan may either send the Department the summary of material reductions in cov- ered services or benefits sent to partici- pants and beneficiaries, or the plan (or is- suer) may use the model described above. In all cases, the exemption is not effective until 30 days after notice has been sent. Burden: 1998–3 I.R.B25January 20, 1998 YearTotalTotalAverageBurdenCost RespondentsResponsesTime perHours(range) (range)(range)Response(range) (range) 1998––––– 1999890 to 4,092261,000 to 1.2 MM2 minutes2,133 to 9,975$226,000 to $1.1 MM 2000––––– TOTALS890 to 4,092261,000 to 1.2 MM2 minutes2,133 to 9,975$226,000 to $1.1 MM Availability of documentation:Nonfed- eral governmental plans that take the ex- emption, or issuers that provide coverage for such plans, must make available to participants and beneficiaries, on request and at no charge, a summary of the data used to calculate the exemption of this section. The summary of data must in- clude the incurred expenditures (includ- ing identification of the portion of the total representing claims and the portion of the total representing administrative expenses), the base period, the claims in- curred during the base period that would have been denied under the terms of the plan absent amendments required to com- ply with parity, and the administrative ex- penses attributable to complying with the parity requirements. Burden: YearTotalTotalAverageBurdenCost RespondentsResponsesTime perHours(range) (range)(range)Response(range) (range) 1998––––– 1999890 to 4,0929,700 to 45,3002 minutes79 to 372$8,400 to $39,300 2000890 to 4,0929,700 to 45,3002 minutes79 to 372$8,400 to $39,300 TOTALS890 to 4,09219,400 to 90,6002 minutes158 to 744$16,800 to $78,600 Plans that take the exemption will incur start up costs for preparing to issue the in- formation they must disclose. We esti- mate the start up costs for nonfederal gov- ernmental plans that take this exemption to range from $2.1 million to $5.5 million. Notice of Use of Transition Period: With respect to the increased cost exemp- tion, the interim rules provide in para- graph (g)(3) a transition period for com- pliance with the requirements of paragraph (f). Under paragraph (g)(3), no enforcement action shall be taken against a nonfederal governmental plan that is subject to the MHPArequirements prior to April 1, 1998 solely because the plan claims the increased cost exemption under section 2705(c)(2) of the PHS Act based on assumptions inconsistent with the rules under paragraph (f), provided that the plan is amended to comply with the parity requirements no later than March 31, 1998 and the plan complies with the certain notice requirements. A nonfederal governmental plan satisfies the notice requirements only if such plan provides notice to the Department of Health and Human Services of the plan’s intent to use the transition period by 30 days after the first day of the plan year be- ginning on or after January 1, 1998, but in no event can the notice be provided later than March 31, 1998. Such notice shall include the name of the plan; the name, address, and telephone number of the plan sponsor or plan administrator; the em- ployer identification number; and the plan number. In addition, such notice must be provided at no charge to participants within 30 days after receipt of a written request for such notification. Burden: January 20, 1998261998–3 I.R.B. YearTotalTotalAverageBurdenCost RespondentsResponsesTime perHours(range) (range)(range)Response(range) (range) 1998531 to 2,441531 to 2,4412 minutes4 to17$250 to $1,151 1999––––– 2000––––– TOTALS531 to 2,441531 to 2,4412 minutes4 to17$250 to $1,151 We have submitted a copy of this pro- posed rule to OMB for its review of the information collection requirements in §146.136. These requirements are not ef- fective until they have been approved by OMB. If you comment on any of these infor- mation collection and recordkeeping re- quirements, please mail copies directly to the following: Health Care Financing Administration, Office of Information Services, Information Technology Investment Management Group, Division of HCFAEnterprise Standards, Room C2-26-17, 7500 Security Boulevard, Baltimore, MD 21244-1850. ATTN: John Burke HCFA-2891-IFC We have submitted a copy of this rule to OMB for its review of these informa- tion collections. Anotice will be pub- lished in the Federal Registerwhen ap- proval is obtained. Interested persons are invited to send comments regarding this burden or any other aspect of these collec- tions of information. If you comment on these information collection and record- keeping requirements, please mail copies directly to the following addresses: Office of Information and Regulatory Affairs Office of Management and Budget Room 10235 New Executive Office Building Washington, DC 20530, Attn: Allison Herron Eydt, HCFADesk Officer. DATED: Gerald B. Lindrew Deputy Director, Pension and Welfare Benefits Administration, Office of Policy and Research Statutory Authority The Department of the Treasury tempo- rary rule is adopted pursuant to the author- ity contained in sections 7805 and 9833 of the Code (26 U.S.C. 7805, 9833), as amended by HIPAA(Pub. L. 104–191, 110 Stat. 1936) and the Taxpayer Relief Act of 1997 (Pub. L. 105–34, 111 Stat. 788). The Department of Labor interim final rule is adopted pursuant to the authority contained in sections 107, 209, 505, 701– 703, 711, 712, and 731–734 of ERISA(29 U.S.C. 1027, 1059, 1135, 1171–1173, 1181, 1182, and 1191-1194), as amended by HIPAA(Pub. L. 104–191, 110 Stat. 1936) and MHPA(Pub. L. 104–204, 110 Stat. 2944), and Secretary of Labor’s Order No. 1–87, 52 FR 13139, April 21, 1987. The Department of Health and Human Services interim final rule is adopted pur- suant to the authority contained in sec- tions 2701, 2702, 2705, 2711, 2712, 2713, 2721, 2722, 2723, and 2792 of the PHS Act (42 U.S.C. 300gg, 300gg–1, 300gg–5, 300gg–11, 300gg–12, 300gg- 13, 300gg–21, 300gg–22, 300gg–23, and 300gg-92), as established by HIPAA (Pub. L. 104–191, 110 Stat. 1936) and MHPA(Pub. L. 104–204, 110 Stat. 2944). * * * * * Adoption of Amendments to the Regulations Internal Revenue Service 26 CFR Chapter I Accordingly, 26 CFR Part 54 is amended as follows: PART54—PENSION EXCISE TAXES Paragraph 1. The authority citation for part 54 is amended by revising the entries for §§54.9801–1Tthrough 54.9801–6T and 54.9802–1T, by removing the entries for §§54.9804–1Tand 54.9806–1T, and by adding entries for §§54.9812–1T, 54.9831–1T, and 54.9833–1Tto read in part as follows: Authority: 26 U.S.C. 7805 * * * Section 54.9801–1Talso issued under 26 U.S.C. 9833. Section 54.9801–2Talso issued under 26 U.S.C. 9833. Section 54.9801–3Talso issued under 26 U.S.C. 9833. Section 54.9801–4Talso issued under 26 U.S.C. 9833. Section 54.9801–5Talso issued under 26 U.S.C. 9801(c)(4), 9801(e)(3), and 9833. Section 54.9801–6Talso issued under 26 U.S.C. 9833. Section 54.9802–1Talso issued under 26 U.S.C. 9833. Section 54.9812–1Talso issued under 26 U.S.C. 9833. Section 54.9831–1Talso issued under 26 U.S.C. 9833. Section 54.9833–1Talso issued under 26 U.S.C. 9833. Par. 2. In §54.9801–1T, paragraph (a) is revised to read as follows: §54.9801–1TBasis and scope (temporary). (a) Statutory basis.Sections 54.9801– 1Tthrough 54.9801-6T, 54.9802–1T, 54.9812–1T, 54.9831–1Tand 54.9833– 1T(portability sections) implement Chap- ter 100 of Subtitle K of the Internal Rev- enue Code of 1986. * * * * * Par. 3. Section 54.9801-2Tis amended by: 1. Revising the introductory text. 2. Revising the definition of excepted benefits. 3. Revising the definition of health in- surance coverage. The revisions read as follows: §54.9801–2TDefinitions (temporary). Unless otherwise provided, the defini- tions in this section govern in applying the provisions of §§54.9801–1Tthrough 54.9801–6T, 54.9802–1T, 54.9812–1T, 54.9831–1T, and 54.9833–1T. * * * * * Excepted benefitsmeans the benefits described as excepted in §54.9831–1T(b). * * * * * Health insurance coveragemeans ben- efits consisting of medical care (provided directly, through insurance or reimburse- ment, or otherwise) under any hospital or medical service policy or certificate, hos- pital or medical service plan contract, or HMO contract offered by a health insur- ance issuer. However, benefits described in §54.9831–1T(b)(2) are not treated as benefits consisting of medical care. * * * * * Par. 4. In §54.9801–4T, paragraph (a)(2) is revised to read as follows: §54.9801–4TRules relating to creditable coverage (temporary). (a) * * * (2) Excluded coverage.Creditable coverage does not include coverage con- sisting solely of coverage of excepted benefits (described in §54.9831–1T). * * * * * Par. 5. In §54.9801–5T, the first sen- tence of paragraph (a)(3)(vi) is revised to read as follows: §54.9801–5TCertification and disclosure of previous coverage (temporary). (a) * * * (3) * * * (vi) Excepted benefits; categories of benefits. No certificate is required to be furnished with respect to excepted bene- fits described in §54.9831–1T. * * * * * * * * §54.9804–1T[Redesignated as §54.9831–1T] Par. 6. Section 54.9804–1Tis redesig- nated as §54.9831–1Tand revised in paragraph (b)(1) to read as follows: §54.9831–1TSpecial rules relating to group health plans (temporary). * * * * * (b) Excepted benefits—(1) In general. The requirements of §§54.9801–1T through 54.9801–6T, 54.9802–1T, and 54.9812–1Tdo not apply to any group health plan in relation to its provision of the benefits described in paragraph (b)(2), (3), (4), or (5) of this section (or any com- bination of these benefits). * * * * * §54.9806–1T[Redesignated as §54.9833–1T] Par. 7. Section 54.9806–1Tis redesig- nated as §54.9833–1Tand amended by: 1. Revising redesignated paragraph (a)(1). 2. Revising the first sentence of redes- ignated paragraph (a)(2). The revisions read as follows: §54.9833–1TEffective dates (temporary). (a) General effective dates—(1) Non- collectively-bargained plans.Except as otherwise provided in this section, Chap- ter 100 of Subtitle K and §§54.9801–1T through 54.9806–1T, 54.9802–1T, and 54.9831–1Tapply with respect to group health plans for plan years beginning after June 30, 1997. (2) Collectively bargained plans.Ex- cept as otherwise provided in this section (other than paragraph (a)(1) of this sec- tion), in the case of a group health plan maintained pursuant to one or more col- lective bargaining agreements between employee representatives and one or more employers ratified before August 21, 1996, Chapter 100 of Subtitle K and §§54.9801–1Tthrough 54. 9801–6T, 54.9802–1T, and 54.9831–1Tdo not apply to plan years beginning before the later of July 1, 1997, or the date on which the last of the collective bargaining agree- ments relating to the plan terminates (de- termined without regard to any extension thereof agreed to after August 21, 1996). * * * * * * * * Par. 8. Section 54.9812–1Tis added to read as follows: §54.9812–1TParity in the application of certain limits to mental health benefits (temporary). (a) Definitions.For purposes of this section, except where the context clearly indicates otherwise, the following defini- tions apply: Aggregate lifetime limitmeans a dollar limitation on the total amount of specified benefits that may be paid under a group 1998–3 I.R.B27January 20, 1998 health plan for an individual (or for a group of individuals considered a single unit in applying this dollar limitation, such as a family or an employee plus spouse). Annual limitmeans a dollar limitation on the total amount of specified benefits that may be paid in a 12-month period under a plan for an individual (or for a group of individuals considered a single unit in applying this dollar limitation, such as a family or an employee plus spouse). Medical/surgical benefitsmeans bene- fits for medical or surgical services, as de- fined under the terms of the plan, but does not include mental health benefits. Mental health benefitsmeans benefits for mental health services, as defined under the terms of the plan, but does not include benefits for treatment of sub- stance abuse or chemical dependency. (b) Requirements regarding limits on benefits—(1) In general—(i) General parity requirement.Agroup health plan that provides both medical/surgical bene- fits and mental health benefits must com- ply with paragraph (b)(2), (3), or (6) of this section. (ii) Exception.The rule in paragraph (b)(1)(i) of this section does not apply if a plan satisfies the requirements of para- graph (e) or (f) of this section. (2) Plan with no limit or limits on less than one-third of all medical/surgical benefits.If a plan does not include an ag- gregate lifetime or annual limit on any medical/surgical benefits or includes ag- gregate lifetime or annual limits that apply to less than one-third of all med- ical/surgical benefits, it may not impose an aggregate lifetime or annual limit, re- spectively, on mental health benefits. (3) Plan with a limit on at least two- thirds of all medical/surgical benefits.If a plan includes an aggregate lifetime or annual limit on at least two-thirds of all medical/surgical benefits, it must either— (i) Apply the aggregate lifetime or an- nual limit both to the medical/surgical benefits to which the limit would other- wise apply and to mental health benefits in a manner that does not distinguish be- tween the medical/surgical and mental health benefits; or (ii) Not include an aggregate lifetime or annual limit on mental health benefits that is less than the aggregate lifetime or annual limit, respectively, on the med- ical/surgical benefits. (4) Examples.The rules of paragraphs (b)(2) and (3) of this section are illus- trated by the following examples: Example 1.(i) Prior to the effective date of the mental health parity provisions, a group health plan had no annual limit on medical/surgical benefits and had a $10,000 annual limit on mental health bene- fits. To comply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the following options: (A) Eliminating the plan’s annual limit on mental health benefits; (B) Replacing the plan’s previous annual limit on mental health benefits with a $500,000 annual limit on all benefits (including medical/surgical and men- tal health benefits); and (C) Replacing the plan’s previous annual limit on mental health benefits with a $250,000 annual limit on medical/surgical benefits and a $250,000 annual limit on mental health benefits. (ii) In this Example 1,each of the three options being considered by the plan sponsor would comply with the requirements of this section because they offer parity in the dollar limits placed on medical/surgical and mental health benefits. Example 2. (i) Prior to the effective date of the mental health parity provisions, a group health plan had a $100,000 annual limit on medical/surgical in- patient benefits, a $50,000 annual limit on medical/surgical outpatient benefits, and a $100,000 annual limit on all mental health benefits. To com- ply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the fol- lowing options: (A) Replacing the plan’s previous annual limit on mental health benefits with a $150,000 annual limit on mental health benefits; and (B) Replacing the plan’s previous annual limit on mental health benefits with a $100,000 annual limit on mental health inpatient benefits and a $50,000 annual limit on mental health outpatient benefits. (ii) In this Example 2, each option under consid- eration by the plan sponsor would comply with the requirements of this section because they offer par- ity in the dollar limits placed on medical/surgical and mental health benefits. Example 3.(i) Agroup health plan that is sub- ject to the requirements of this section has no aggre- gate lifetime or annual limit for either medical/surgi- cal benefits or mental health benefits. While the plan provides medical/surgical benefits with respect to both network and out-of-network providers, it does not provide mental health benefits with respect to out-of-network providers. (ii) In this Example 3,the plan complies with the requirements of this section because they offer par- ity in the dollar limits placed on medical/surgical and mental health benefits. Example 4.(i) Prior to the effective date of the mental health parity provisions, a group health plan had an annual limit on medical/surgical benefits and a separate but identical annual limit on mental health benefits. The plan included benefits for treatment of substance abuse and chemical dependency in its def- inition of mental health benefits. Accordingly, claims paid for treatment of substance abuse and chemical dependency were counted in applying the annual limit on mental health benefits. To comply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the following options: (A) Making no change in the plan so that claims paid for treatment of substance abuse and chemical dependency continue to count in applying the annual limit on mental health benefits; (B) amending the plan to count claims paid for treatment of substance abuse and chemical depen- dency in applying the annual limit on medical/surgi- cal benefits (rather than counting those claims in ap- plying the annual limit on mental health benefits); (C) amending the plan to provide a new category of benefits for treatment of chemical dependency and substance abuse that is subject to a separate, lower limit and under which claims paid for treat- ment of substance abuse and chemical dependency are counted only in applying the annual limit on this separate category; and (D) amending the plan to eliminate distinctions between medical/surgical benefits and mental health benefits and establishing an overall limit on benefits offered under the plan under which claims paid for treatment of substance abuse and chemical depen- dency are counted with medical/surgical benefits and mental health benefits in applying the overall limit. (ii) In this Example 4,the group health plan is described in paragraph (b)(3) of this section. Be- cause mental health benefits are defined in para- graph (a) of this section as excluding benefits for treatment of substance abuse and chemical depen- dency, the inclusion of benefits for treatment of sub- stance abuse and chemical dependency in applying an aggregate lifetime limit or annual limit on mental health benefits under option (A) of this Example 4 would not comply with the requirements of para- graph (b)(3) of this section. However, options (B), (C), and (D) of this Example 4 would comply with the requirements of paragraph (b)(3) of this section because they offer parity in the dollar limits placed on medical/surgical and mental health benefits. (5) Determining one-third and two- thirds of all medical/surgical benefits. For purposes of this paragraph (b), the de- termination of whether the portion of medical/surgical benefits subject to a limit represents one-third or two-thirds of all medical/surgical benefits is based on the dollar amount of all plan payments for medical/surgical benefits expected to be paid under the plan for the plan year (or for the portion of the plan year after a change in plan benefits that affects the ap- plicability of the aggregate lifetime or an- nual limits). Any reasonable method may be used to determine whether the dollar amounts expected to be paid under the plan will constitute one-third or two- thirds of the dollar amount of all plan pay- ments for medical/surgical benefits. (6)Plan not described in paragraph (b)(2) or (3) of this section—(i) In gen- eral.Agroup health plan that is not de- scribed in paragraph (b)(2) or (3) of this section, must either— January 20, 1998281998–3 I.R.B. (A) Impose no aggregate lifetime or an- nual limit, as appropriate, on mental health benefits; or (B) Impose an aggregate lifetime or an- nual limit on mental health benefits that is no less than an average limit for med- ical/surgical benefits calculated in the fol- lowing manner. The average limit is cal- culated by taking into account the weighted average of the aggregate life- time or annual limits, as appropriate, that are applicable to the categories of med- ical/surgical benefits. Limits based on de- livery systems, such as inpatient/outpa- tient treatment or normal treatment of common, low-cost conditions (such as treatment of normal births), do not consti- tute categories for purposes of this para- graph (b)(6)(i)(B). In addition, for pur- poses of determining weighted averages, any benefits that are not within a category that is subject to a separately-designated limit under the plan are taken into account as a single separate category by using an estimate of the upper limit on the dollar amount that a plan may reasonably be ex- pected to incur with respect to such bene- fits, taking into account any other applica- ble restrictions under the plan. (ii) Weighting.For purposes of this paragraph (b)(6), the weighting applica- ble to any category of medical/surgical benefits is determined in the manner set forth in paragraph (b)(5) of this section for determining one-third or two-thirds of all medical/surgical benefits. (iii) Example.The rules of this para- graph (b)(6) are illustrated by the follow- ing example: Example.(i) Agroup health plan that is subject to the requirements of this section includes a $100,000 annual limit on medical/surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual limit on any other category of medical/surgical benefits. The plan determines that 40% of the dollar amount of plan payments for med- ical/surgical benefits are related to cardio-pul- monary diseases. The plan determines that $1,000,000 is a reasonable estimate of the upper limit on the dollar amount that the plan may incur with respect to the other 60% of payments for med- ical/surgical benefits. (ii) In this Example,the plan is not described in paragraph (b)(3) of this section because there is not one annual limit that applies to at least two-thirds of all medical/surgical benefits. Further, the plan is not described in paragraph (b)(2) of this section because more than one-third of all medical/surgical benefits are subject to an annual limit. Under this paragraph (b)(6), the plan sponsor can choose either to include no annual limit on mental health benefits, or to in- clude an annual limit on mental health benefits that is not less than the weighted average of the annual limits applicable to each category of medical/surgi- cal benefits. In this example, the minimum weighted average annual limit that can be applied to mental health benefits is $640,000 (40% 3 $100,000 + 60% x $1,000,000 = $640,000). (c) Rule in the case of separate benefit packages. If a group health plan offers two or more benefit packages, the re- quirements of this section, including the exemption provisions in paragraph (f) of this section, apply separately to each ben- efit package. Examples of a group health plan that offers two or more benefit pack- ages include a group health plan that of- fers employees a choice between indem- nity coverage or HMO coverage, and a group health plan that provides one bene- fit package for retirees and a different benefit package for current employees. (d) Applicability—(1) Group health plans.The requirements of this section apply to a group health plan offering both medical/surgical benefits and mental health benefits regardless of whether the mental health benefits are administered separately under the plan. (2) Health insurance issuers.See 29 CFR 2590.712(d)(2) and 45 CFR 146.136(d)(2), which provide that health insurance issuers offering health insur- ance coverage for both medical/surgical benefits and mental health benefits in connection with a group health plan are subject to rules similar to those applicable to group health plans under this section. (3) Scope.This section does not— (i) Require a group health plan to pro- vide any mental health benefits; or (ii) Affect the terms and conditions (in- cluding cost sharing, limits on the number of visits or days of coverage, require- ments relating to medical necessity, re- quiring prior authorization for treatment, or requiring primary care physicians’re- ferrals for treatment) relating to the amount, duration, or scope of the mental health benefits under the plan except as specifically provided in paragraph (b) of this section. (e) Small employer exemption—(1) In general.The requirements of this section do not apply to a group health plan for a plan year of a small employer. For pur- poses of this paragraph (e), the term small employermeans, in connection with a group health plan with respect to a calen- dar year and a plan year, an employer who employed an average of at least two but not more than 50 employees on business days during the preceding calendar year and who employs at least two employees on the first day of the plan year. See sec- tion 9831(a) and §54.9831–1T(a), which provide that this section (and certain other sections) does not apply to any group health plan for any plan year if, on the first day of the plan year, the plan has fewer than two participants who are cur- rent employees. (2) Rules in determining employer size. For purposes of paragraph (e)(1) of this section— (i) All persons treated as a single em- ployer under subsections (b), (c), (m), and (o) of section 414 are treated as one em- ployer; (ii) If an employer was not in existence throughout the preceding calendar year, whether it is a small employer is deter- mined based on the average number of employees the employer reasonably ex- pects to employ on business days during the current calendar year; and (iii) Any reference to an employer for purposes of the small employer exemp- tion includes a reference to a predecessor of the employer. (f) Increased cost exemption—(1) In general.Agroup health plan is not sub- ject to the requirements of this section if the requirements of this paragraph (f) are satisfied. If a plan offers more than one benefit package, this paragraph (f) applies separately to each benefit package. Ex- cept as provided in paragraph (h) of this section, a plan must comply with the re- quirements of paragraph (b)(1)(i) of this section for the first plan year beginning on or after January 1, 1998, and must con- tinue to comply with the requirements of paragraph (b)(1)(i) of this section until the plan satisfies the requirements in this paragraph (f). In no event is the exemp- tion of this paragraph (f) effective until 30 days after the notice requirements in para- graph (f)(3) of this section are satisfied. If the requirements of this paragraph (f) are satisfied with respect to a plan, the ex- emption continues in effect (at the plan’s discretion) until September 30, 2001, even if the plan subsequently purchases a different policy from the same or a differ- ent issuer and regardless of any other changes to the plan’s benefit structure. 1998–3 I.R.B29January 20, 1998 (2) Calculation of the one-percent in- crease—(i) Ratio.Agroup health plan satisfies the requirements of this para- graph (f)(2) if the application of para- graph (b)(1)(i) of this section to the plan results in an increase in the cost under the plan of at least one percent. The applica- tion of paragraph (b)(1)(i) of this section results in an increased cost of at least one percent under a group health plan only if the ratio below equals or exceeds 1.01000. The ratio is determined as fol- lows: (A) The incurred expenditures during the base period, divided by, (B) The incurred expenditures during the base period, reduced by—- (1) The claims incurred during the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section; and (2) Administrative expenses attribut- able to complying with the requirements of this section. (ii) Formula.The ratio of paragraph (f)(2)(i) of this section is expressed math- ematically as follows: IE ≥1.01000 IE – (CE + AE) (A) IEmeans the incurred expendi- tures during the base period. (B) CEmeans the claims incurred dur- ing the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section (C) AEmeans administrative costs re- lated to claims in CEand other adminis- trative costs attributable to complying with the requirements of this section. (iii) Incurred expenditures. Incurred expenditures meansactual claims in- curred during the base period and re- ported within two months following the base period, and administrative costs for all benefits under the group health plan, including mental health benefits and med- ical/surgical benefits, during the base pe- riod. Incurred expenditures do not in- clude premiums. (iv) Base period. Base period means the period used to calculate whether the plan may claim the one-percent increased cost exemption in this paragraph (f). The base period must begin on the first day in any plan year that the plan complies with the requirements of paragraph (b)(1)(i) of this section and must extend for a period of at least six consecutive calendar months. However, in no event may the base period begin prior to September 26, 1996 (the date of enactment of the Mental Health Parity Act (Pub. L. 104-204, 110 Stat. 2944)). (v) Rating pools.For plans that are combined in a pool for rating purposes, the calculation under this paragraph (f)(2) for each plan in the pool for the base pe- riod is based on the incurred expenditures of the pool, whether or not all the plans in the pool have participated in the pool for the entire base period. (However, only the plans that have complied with para- graph (b)(1)(i) of this section for at least six months as a member of the pool sat- isfy the requirements of this paragraph (f)(2).) Otherwise, the calculation under this paragraph (f)(2) for each plan is cal- culated by the plan administrator based on the incurred expenditures of the plan. (vi) Examples.The rules of this para- graph (f)(2) are illustrated by the follow- ing examples: Example 1.(i) Agroup health plan has a plan year that is the calendar year. The plan satisfies the requirements of paragraph (b)(1)(i) of this section as of January 1, 1998. On September 15, 1998, the plan determines that $1,000,000 in claims have been incurred during the period between January 1, 1998 and June 30, 1998 and reported by August 30, 1998. The plan also determines that $100,000 in adminis- trative costs have been incurred for all benefits under the group health plan, including mental health benefits. Thus, the plan determines that its incurred expenditures for the base period are $1,100,000. The plan also determines that the claims incurred during the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section are $40,000 and that administrative expenses attributable to comply- ing with the requirements of this section are $10,000. Thus, the total amount of expenditures for the base period had the plan not been amended to comply with the requirements of paragraph (b)(1)(i) of this section are $1,050,000 ($1,100,000 – ($40,000 + $10,000) = $1,050,000). (ii) In this Example 1,the plan satisfies the re- quirements of this paragraph (f)(2) because the ap- plication of this section results in an increased cost of at least one percent under the terms of the plan ($1,100,000/$1,050,000 = 1.04762). Example 2.(i) Ahealth insurance issuer sells a group health insurance policy that is rated on a pooled basis and is sold to 30 group health plans. One of the group health plans inquires whether it qualifies for the one-percent increased cost exemp- tion. The issuer performs the calculation for the pool as a whole and determines that the application of this section results in an increased cost of 0.500 percent (for a ratio under this paragraph (f)(2) of 1.00500) for the pool. The issuer informs the re- questing plan and the other plans in the pool of the calculation. (ii) In this Example 2,none of the plans satisfy the requirements of this paragraph (f)(2) and a plan that purchases a policy not complying with the re- quirements of paragraph (b)(1)(i) of this section vio- lates the requirements of this section. Example 3.(i) Apartially insured plan is collect- ing the information to determine whether it qualifies for the exemption. The plan administrator deter- mines the incurred expenses for the base period for the self-funded portion of the plan to be $2,000,000 and the administrative expenses for the base period for the self-funded portion to be $200,000. For the insured portion of the plan, the plan administrator requests data from the insurer. For the insured por- tion of the plan, the plan’s own incurred expenses for the base period are $1,000,000 and the adminis- trative expenses for the base period are $100,000. The plan administrator determines that under the self-funded portion of the plan, the claims incurred for the base period that would have been denied under the terms of the plan absent the amendment are $0 because the self-funded portion does not cover mental health benefits and the plan’s adminis- trative costs attributable to complying with the re- quirements of this section are $1,000. The issuer de- termines that under the insured portion of the plan, the claims incurred for the base period that would have been denied under the terms of the plan absent the amendment are $25,000 and the administrative costs attributable to complying with the require- ments of this section are $1,000. Thus, the total in- curred expenditures for the plan for the base period are $3,300,000 ($2,000,000 + $200,000 + $1,000,000 + $100,000 = $3,300,000) and the total amount of expenditures for the base period had the plan not been amended to comply with the require- ments of paragraph (b)(1)(i) of this section are $3,273,000 ($3,300,000 – ($0 + $1,000 + $25,000 + $1,000) = $3,273,000). (ii) In this Example 3,the plan does not satisfy the requirements of this paragraph (f)(2) because the application of this section does not result in an in- creased cost of at least one percent under the terms of the plan ($3,300,000/$3,273,000 = 1.00825). (3) Notice of exemption—(i) Partici- pants and beneficiaries—(A) In general. Agroup health plan must notify partici- pants and beneficiaries of the plan’s deci- sion to claim the one-percent increased cost exemption. The notice must include the following information: (1) Astatement that the plan is exempt from the requirements of this section and a description of the basis for the exemp- tion; (2) The name and telephone number of the individual to contact for further infor- mation; (3) The plan name and plan number (PN); (4) The plan administrator’s name, ad- dress, and telephone number; January 20, 1998301998–3 I.R.B. (5) For single-employer plans, the plan sponsor’s name, address, and telephone number (if different from paragraph (f)(3)(i)(A)(3) of this section) and the plan sponsor’s employer identification number (EIN); (6) The effective date of the exemption; (7) The ability of participants and bene- ficiaries to contact the plan administrator to see how benefits may be affected as a result of the plan’s claim of the exemp- tion; and (8) The availability, upon request and free of charge, of a summary of the infor- mation required under paragraph (f)(4) of this section. (B) Use of summary of material reduc- tions in covered services or benefits.A plan may satisfy the requirements of para- graph (f)(3)(i)(A) of this section by pro- viding participants and beneficiaries (in accordance with paragraph (f)(3)(i)(C) of this section) with a summary of material reductions in covered services or benefits required under 29 CFR 2520.104b-3(d) that also includes the information of this paragraph (f)(3)(i). However, in all cases, the exemption is not effective until 30 days after notice has been sent. (C) Delivery.The notice described in this paragraph (f)(3)(i) is required to be provided to all participants and beneficia- ries. The notice may be furnished by any method of delivery that satisfies the re- quirements of section 104(b)(1) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1024(b)(1)) (e.g., first-class mail). If the notice is provided to the participant at the participant’s last known address, then the requirements of this paragraph (f)(3)(i) are satisfied with respect to the participant and all benefi- ciaries residing at that address. If a bene- ficiary’s last known address is different from the participant’s last known address, a separate notice is required to be pro- vided to the beneficiary at the benefi- ciary’s last known address. (D) Example.The rules of this para- graph (f)(3)(i) are illustrated by the fol- lowing example: E xample.(i) Agroup health plan has a plan year that is the calendar year and has an open enrollment period every November 1 through November 30. The plan determines on September 15 that it satis- fies the requirements of paragraph (f)(2) of this sec- tion. As part of its open enrollment materials, the plan mails, on October 15, to all participants and beneficiaries a notice satisfying the requirements of this paragraph (f)(3)(i). (ii) In this Example,the plan has sent the notice in a manner that complies with this paragraph (f)(3)(i). (ii) Federal agencies.Agroup health plan that is a church plan (as defined in section 414(e)) claiming the exemption of this paragraph (f) for any benefit package must provide notice in accordance with the requirement of this paragraph (f)(3)(ii). This requirement is satisfied if the plan sends a copy, to the address designated by the Secretary in generally applicable guid- ance, of the notice described in paragraph (f)(3)(i) of this section identifying the ben- efit package to which the exemption ap- plies. For any other group health plan, see 29 CFR 2590.712(f)(3)(ii)(B). (4) Availability of documentation.The plan must make available to participants and beneficiaries (or their representa- tives), on request and at no charge, a sum- mary of the information on which the ex- emption was based. An individual who is not a participant or beneficiary and who presents a notice described in paragraph (f)(3)(i) of this section is considered to be a representative. Arepresentative may request the summary of information by providing the plan a copy of the notice provided to the participant under para- graph (f)(3)(i) of this section with any in- dividually identifiable information redacted. The summary of information must include the incurred expenditures, the base period, the dollar amount of claims incurred during the base period that would have been denied under the terms of the plan absent amendments re- quired to comply with paragraph (b)(1)(i) of this section, the administrative costs re- lated to those claims, and other adminis- trative costs attributable to complying with the requirements of this section. In no event should the summary of informa- tion include any individually identifiable information. (g) Special rules for group health in- surance coverage—(1) Sale of nonparity policies.See 29 CFR 2590.712(g)(1) and 45 CFR 146.136(g)(1) for rules limiting the right of an issuer to sell a policy with- out parity (as described in 29 CFR 2590.712(b) and 45 CFR 146.136(b)) to a plan that meets the requirements of 29 CFR 2590.712(e) or (f) and 45 CFR 146.136(e) or (f)). (2) Duration of exemption.After a plan meets the requirements of paragraph (f) of this section, the plan may change issuers without having to meet the requirements of paragraph (f) of this section again be- fore September 30, 2001. (h) Effective dates—(1) In general. The requirements of this section are ap- plicable for plan years beginning on or after January 1, 1998. (2) Limitation on actions(i) Except as provided in paragraph (h)(3) of this sec- tion, no enforcement action is to be taken by the Secretary against a group health plan that has sought to comply in good faith with the requirements of section 9812, with respect to a violation that oc- curs before the earlier of— (A) The first day of the first plan year beginning on or after April 1, 1998; or (B) January 1, 1999. (ii) Compliance with the requirements of this section is deemed to be good faith compliance with the requirements of sec- tion 9812. (iii) The rules of this paragraph (h)(2) are illustrated by the following examples: Example 1.(i) Agroup health plan has a plan year that is the calendar year. The plan complies with section 9812 in good faith using assumptions inconsistent with paragraph (b)(6) of this section re- lating to weighted averages for categories of bene- fits. (ii) In this Example 1, no enforcement action may be taken against the plan with respect to a vio- lation resulting solely from those assumptions and occurring before January 1, 1999. Example 2. (i) Agroup health plan has a plan year that is the calendar year. For the entire 1998 plan year, the plan applies a $1,000,000 annual limit on medical/surgical benefits and a $100,000 annual limit on mental health benefits. (ii) In this Example 2, the plan has not sought to comply with the requirements of section 9812 in good faith, and this paragraph (h)(2) does not apply. (3) Transition period for increased cost exemption—(i) In general.No enforce- ment action will be taken against a group health plan that is subject to the require- ments of this section based on a violation of this section that occurs before April 1, 1998 solely because the plan claims the increased cost exemption under section 9812(c)(2) based on assumptions incon- sistent with the rules under paragraph (f) of this section, provided that a plan amendment that complies with the re- quirements of paragraph (b)(1)(i) of this section is adopted and effective no later than March 31, 1998 and the plan com- plies with the notice requirements in para- graph (h)(3)(ii) of this section. 1998–3 I.R.B31January 20, 1998 (ii) Notice of plan’s use of transition period.(A) Agroup health plan satisfies the requirements of this paragraph (h)(3)(ii) only if the plan provides notice to the applicable federal agency and posts the notice at the location(s) where docu- ments must be made available for exami- nation by participants and beneficiaries under section 104(b)(2) of the Employee Retirement Income Security Act of 1974, and the regulations thereunder (29 CFR 2520.104b-1(b)(3)). The notice must in- dicate the plan’s decision to use the transi- tion period in paragraph (h)(3)(i) of this section by 30 days after the first day of the plan year beginning on or after Janu- ary 1, 1998, but in no event later than March 31, 1998. For a group health plan that is a church plan (as defined in section 414(e)), the applicable federal agency is the Department of the Treasury. For a group health plan that is not a church plan, see 29 CFR 2590.712(h)(3)(ii). The notice must include— (1) The name of the plan and the plan number (PN); (2) The name, address, and telephone number of the plan administrator; (3) For single-employer plans, the name, address, and telephone number of the plan sponsor (if different from the plan administrator) and the plan sponsor’s employer identification number (EIN); (4) The name and telephone number of the individual to contact for further infor- mation; and (5) The signature of the plan adminis- trator and the date of the signature. (B) The notice must be provided at no charge to participants or their representa- tive within 15 days after receipt of a writ- ten or oral request for such notification, but in no event before the notice has been sent to the applicable federal agency. (i) Sunset.This section does not apply to benefits for services furnished on or after September 30, 2001. Deputy Commissioner of Internal Revenue. Acting Assistant Secretary of the Treasury. Pension and Welfare Benefits Administration 29 CFR Chapter XXV 29 CFR Part 2590 is amended as fol- lows: PART2590—RULES AND REGULATIONS FOR HEALTH INSURANCE PORTABILITYAND RENEWABILITYFOR GROUP HEALTH PLANS 1. The authority citation for Part 2590 is revised to read as follows: Authority:Secs. 107, 209, 505, 701- 703, 711, 712, and 731-734 of ERISA(29 U.S.C. 1027, 1059, 1135, 1171-1173, 1181, 1182, and 1191-1194), as amended by Pub. L. 104-191, 110 Stat. 1936) and Pub. L. 104-204, 110 Stat. 2944; and Sec- retary of Labor’s Order No. 1-87, 52 FR 13139, April 21, 1987. Subpart B—OtherRequirements 2. Section 2590.712 is revised to read as follows: § 2590.712 Parity in the application of certain limits to mental health benefits. (a) Definitions. For purposes of this section, except where the context clearly indicates otherwise, the following defini- tions apply: Aggregate lifetime limitmeans a dollar limitation on the total amount of specified benefits that may be paid under a group health plan (or group health insurance coverage offered in connection with such a plan) for an individual (or for a group of individuals considered a single unit in ap- plying this dollar limitation, such as a family or an employee plus spouse). Annual limitmeans a dollar limitation on the total amount of specified benefits that may be paid in a 12-month period under a plan (or group health insurance coverage offered in connection with such a plan) for an individual (or for a group of individuals considered a single unit in ap- plying this dollar limitation, such as a family or an employee plus spouse). Medical/surgical benefitsmeans bene- fits for medical or surgical services, as de- fined under the terms of the plan or group health insurance coverage, but does not include mental health benefits. Mental health benefitsmeans benefits for mental health services, as defined under the terms of the plan or group health insurance coverage, but does not include benefits for treatment of sub- stance abuse or chemical dependency. (b) Requirements regarding limits on benefits—(1) In general—(i) General parity requirement.Agroup health plan (or health insurance coverage offered by an issuer in connection with a group health plan) that provides both medical/surgical benefits and mental health benefits must comply with para- graph (b)(2), (3), or (6) of this section. (ii) Exception. The rule in paragraph (b)(1)(i) of this section does not apply if a plan, or coverage, satisfies the require- ments of paragraph (e) or (f) of this sec- tion. (2) Plan with no limit or limits on less than one-third of all medical/surgical benefits.If a plan (or group health insur- ance coverage) does not include an aggre- gate lifetime or annual limit on any med- ical/surgical benefits or includes aggregate lifetime or annual limits that apply to less than one-third of all med- ical/surgical benefits, it may not impose an aggregate lifetime or annual limit, re- spectively, on mental health benefits. (3) Plan with a limit on at least two- thirds of all medical/surgical benefits.If a plan (or group health insurance cover- age) includes an aggregate lifetime or an- nual limit on at least two-thirds of all medical/surgical benefits, it must either— (i) Apply the aggregate lifetime or an- nual limit both to the medical/surgical benefits to which the limit would other- wise apply and to mental health benefits in a manner that does not distinguish be- tween the medical/surgical and mental health benefits; or (ii) Not include an aggregate lifetime or annual limit on mental health benefits that is less than the aggregate lifetime or annual limit, respectively, on the medical/surgical benefits. (4) Examples.The rules of paragraphs (b)(2) and (3) of this section are illus- trated by the following examples: January 20, 1998321998–3 I.R.B. Example 1. (i) Prior to the effective date of the mental health parity provisions, a group health plan had no annual limit on medical/surgical benefits and had a $10,000 annual limit on mental health bene- fits. To comply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the following options: (A) Eliminating the plan’s annual limit on mental health benefits; (B) Replacing the plan’s previous annual limit on mental health benefits with a $500,000 annual limit on all benefits (including medical/surgical and men- tal health benefits); and (C) Replacing the plan’s previous annual limit on mental health benefits with a $250,000 annual limit on medical/surgical benefits and a $250,000 annual limit on mental health benefits. (ii) In this Example 1,each of the three options being considered by the plan sponsor would comply with the requirements of this section because they offer parity in the dollar limits placed on medical/surgical and mental health benefits. Example 2.(i) Prior to the effective date of the mental health parity provisions, a group health plan had a $100,000 annual limit on medical/surgical in- patient benefits, a $50,000 annual limit on medical/surgical outpatient benefits, and a $100,000 annual limit on all mental health benefits. To com- ply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the fol- lowing options: (A) Replacing the plan’s previous annual limit on mental health benefits with a $150,000 annual limit on mental health benefits; and (B) Replacing the plan’s previous annual limit on mental health benefits with a $100,000 annual limit on mental health inpatient benefits and a $50,000 annual limit on mental health outpatient benefits. (ii) In this Example 2,each option under consid- eration by the plan sponsor would comply with the requirements of this section because they offer par- ity in the dollar limits placed on medical/surgical and mental health benefits. Example 3.(i) Agroup health plan that is sub- ject to the requirements of this section has no aggre- gate lifetime or annual limit for either medical/surgi- cal benefits or mental health benefits. While the plan provides medical/surgical benefits with respect to both network and out-of-network providers, it does not provide mental health benefits with respect to out-of-network providers. (ii) In thisExample 3,the plan complies with the requirements of this section because they offer par- ity in the dollar limits placed on medical/surgical and mental health benefits. Example 4.(i) Prior to the effective date of the mental health parity provisions, a group health plan had an annual limit on medical/surgical benefits and a separate but identical annual limit on mental health benefits. The plan included benefits for treatment of substance abuse and chemical dependency in its def- inition of mental health benefits. Accordingly, claims paid for treatment of substance abuse and chemical dependency were counted in applying the annual limit on mental health benefits. To comply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the following options: (A) Making no change in the plan so that claims paid for treatment of substance abuse and chemical dependency continue to count in applying the annual limit on mental health benefits; (B) amending the plan to count claims paid for treatment of substance abuse and chemical depen- dency in applying the annual limit on medical/surgi- cal benefits (rather than counting those claims in ap- plying the annual limit on mental health benefits); (C) amending the plan to provide a new category of benefits for treatment of chemical dependency and substance abuse that is subject to a separate, lower limit and under which claims paid for treat- ment of substance abuse and chemical dependency are counted only in applying the annual limit on this separate category; and (D) amending the plan to eliminate distinctions between medical/surgical benefits and mental health benefits and establishing an overall limit on benefits offered under the plan under which claims paid for treatment of substance abuse and chemical depen- dency are counted with medical/surgical benefits and mental health benefits in applying the overall limit. (ii) In this Example 4,the group health plan is described in paragraph (b)(3) of this section. Be- cause mental health benefits are defined in para- graph (a) of this section as excluding benefits for treatment of substance abuse and chemical depen- dency, the inclusion of benefits for treatment of sub- stance abuse and chemical dependency in applying an aggregate lifetime limit or annual limit on mental health benefits under option (A) of this Example 4 would not comply with the requirements of para- graph (b)(3) of this section. However, options (B), (C), and (D) of this Example 4would comply with the requirements of paragraph (b)(3) of this section because they offer parity in the dollar limits placed on medical/surgical and mental health benefits. (5) Determining one-third and two- thirds of all medical/surgical benefits. For purposes of this paragraph (b), the de- termination of whether the portion of medical/surgical benefits subject to a limit represents one-third or two-thirds of all medical/surgical benefits is based on the dollar amount of all plan payments for medical/surgical benefits expected to be paid under the plan for the plan year (or for the portion of the plan year after a change in plan benefits that affects the ap- plicability of the aggregate lifetime or an- nual limits). Any reasonable method may be used to determine whether the dollar amounts expected to be paid under the plan will constitute one-third or two- thirds of the dollar amount of all plan pay- ments for medical/surgical benefits. (6) Plan not described in paragraph (b)(2) or (3) of this section—(i) In gen- eral. Agroup health plan (or group health insurance coverage) that is not described in paragraph (b)(2) or (3) of this section, must either— (A) Impose no aggregate lifetime or an- nual limit, as appropriate, on mental health benefits; or (B) Impose an aggregate lifetime or an- nual limit on mental health benefits that is no less than an average limit calculated for medical/surgical benefits in the fol- lowing manner. The average limit is cal- culated by taking into account the weighted average of the aggregate life- time or annual limits, as appropriate, that are applicable to the categories of med- ical/surgical benefits. Limits based on de- livery systems, such as inpatient/outpa- tient treatment or normal treatment of common, low-cost conditions (such as treatment of normal births), do not consti- tute categories for purposes of this para- graph (b)(6)(i)(B). In addition, for pur- poses of determining weighted averages, any benefits that are not within a category that is subject to a separately-designated limit under the plan are taken into account as a single separate category by using an estimate of the upper limit on the dollar amount that a plan may reasonably be ex- pected to incur with respect to such bene- fits, taking into account any other applica- ble restrictions under the plan. (ii) Weighting.For purposes of this paragraph (b)(6), the weighting applica- ble to any category of medical/surgical benefits is determined in the manner set forth in paragraph (b)(5) of this section for determining one-third or two-thirds of all medical/surgical benefits. (iii) Example.The rules of this para- graph (b)(6) are illustrated by the follow- ing example: Example. (i) Agroup health plan that is subject to the requirements of this section includes a $100,000 annual limit on medical/surgical benefits related to cardio- pulmonary diseases. The plan does not include an annual limit on any other cate- gory of medical/surgical benefits. The plan deter- mines that 40% of the dollar amount of plan pay- ments for medical/surgical benefits are related to cardio-pulmonary diseases. The plan determines that $1,000,000 is a reasonable estimate of the upper limit on the dollar amount that the plan may incur with respect to the other 60% of payments for med- ical/surgical benefits. (ii) In thisExample,the plan is not described in paragraph (b)(3) of this section because there is not one annual limit that applies to at least two-thirds of all medical/surgical benefits. Further, the plan is not described in paragraph (b)(2) of this section because more than one-third of all medical/surgical benefits are subject to an annual limit. Under this paragraph (b)(6), the plan sponsor can choose either to include no annual limit on mental health benefits, or to in- clude an annual limit on mental health benefits that is not less than the weighted average of the annual limits applicable to each category of medical/surgi- cal benefits. In this example, the minimum 1998–3 I.R.B33January 20, 1998 weighted average annual limit that can be applied to mental health benefits is $640,000 (40% x $100,000 + 60% 3$1,000,000 = $640,000). (c) Rule in the case of separate benefit packages.If a group health plan offers two or more benefit packages, the re- quirements of this section, including the exemption provisions in paragraph (f) of this section, apply separately to each ben- efit package. Examples of a group health plan that offers two or more benefit pack- ages include a group health plan that of- fers employees a choice between indem- nity coverage or HMO coverage, and a group health plan that provides one bene- fit package for retirees and a different benefit package for current employees. (d) Applicability—(1) Group health plans. The requirements of this section apply to a group health plan offering both medical/surgical benefits and mental health benefits regardless of whether the mental health benefits are administered separately under the plan. (2) Health insurance issuers.The re- quirements of this section apply to a health insurance issuer offering health in- surance coverage for both medical/surgi- cal benefits and mental health benefits in connection with a group health plan. (3) Scope.This section does not— (i) Require a group health plan (or health insurance issuer offering coverage in connection with a group health plan) to provide any mental health benefits; or (ii) Affect the terms and conditions (in- cluding cost sharing, limits on the number of visits or days of coverage, require- ments relating to medical necessity, re- quiring prior authorization for treatment, or requiring primary care physicians’re- ferrals for treatment) relating to the amount, duration, or scope of the mental health benefits under the plan (or cover- age) except as specifically provided in paragraph (b) of this section. (e) Small employer exemption—(1) In general.The requirements of this section do not apply to a group health plan (or health insurance issuer offering coverage in connection with a group health plan) for a plan year of a small employer. For purposes of this paragraph (e), the term small employermeans, in connection with a group health plan with respect to a cal- endar year and a plan year, an employer who employed an average of at least two but not more than 50 employees on busi- ness days during the preceding calendar year and who employs at least two em- ployees on the first day of the plan year. See section 732(a) of the Act and §2590.732(a), which provide that this sec- tion (and certain other sections) does not apply to any group health plan (and health insurance issuer offering coverage in con- nection with a group health plan) for any plan year if, on the first day of the plan year, the plan has fewer than two partici- pants who are current employees. (2) Rules in determining employer size. For purposes of paragraph (e)(1) of this section— (i) All persons treated as a single em- ployer under subsections (b), (c), (m), and (o) of section 414 of the Internal Revenue Code of 1986 (26 U.S.C. 414) are treated as one employer; (ii) If an employer was not in existence throughout the preceding calendar year, whether it is a small employer is deter- mined based on the average number of employees the employer reasonably ex- pects to employ on business days during the current calendar year; and (iii) Any reference to an employer for purposes of the small employer exemp- tion includes a reference to a predecessor of the employer. (f) Increased cost exemption—(1) In general.Agroup health plan (or health insurance coverage offered in connection with a group health plan) is not subject to the requirements of this section if the re- quirements of this paragraph (f) are satis- fied. If a plan offers more than one bene- fit package, this paragraph (f) applies separately to each benefit package. Ex- cept as provided in paragraph (h) of this section, a plan must comply with the re- quirements of paragraph (b)(1)(i) of this section for the first plan year beginning on or after January 1, 1998, and must con- tinue to comply with the requirements of paragraph (b)(1)(i) of this section until the plan satisfies the requirements in this paragraph (f). In no event is the exemp- tion of this paragraph (f) effective until 30 days after the notice requirements in para- graph (f)(3) of this section are satisfied. If the requirements of this paragraph (f) are satisfied with respect to a plan, the ex- emption continues in effect (at the plan’s discretion) until September 30, 2001, even if the plan subsequently purchases a different policy from the same or a differ- ent issuer and regardless of any other changes to the plan’s benefit structure. (2) Calculation of the one-percent in- crease—(i) Ratio.Agroup health plan (or group health insurance coverage) sat- isfies the requirements of this paragraph (f)(2) if the application of paragraph (b)(1)(i) of this section to the plan (or to such coverage) results in an increase in the cost under the plan (or for such cover- age) of at least one percent. The applica- tion of paragraph (b)(1)(i) of this section results in an increased cost of at least one percent under a group health plan (or for such coverage) only if the ratio below equals or exceeds 1.01000. The ratio is determined as follows: (A) The incurred expenditures during the base period, divided by, (B) The incurred expenditures during the base period, reduced by — (1) The claims incurred during the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section; and (2) Administrative expenses attribut- able to complying with the requirements of this section. (ii) Formula.The ratio of paragraph (f)(2)(i) of this section is expressed math- ematically as follows: IE ≥1.01000 IE – (CE + AE) (A) IEmeans the incurred expendi- tures during the base period. (B) CEmeans the claims incurred dur- ing the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section (C) AEmeans administrative costs re- lated to claims in CE and other adminis- trative costs attributable to complying with the requirements of this section. (iii) Incurred expenditures. Incurred expendituresmeans actual claims in- curred during the base period and re- ported within two months following the base period, and administrative costs for all benefits under the group health plan, including mental health benefits and med- ical/surgical benefits, during the base pe- riod. Incurred expenditures do not in- clude premiums. (iv) Base period. Base period means the period used to calculate whether the January 20, 1998341998–3 I.R.B. plan may claim the one-percent increased cost exemption in this paragraph (f). The base period must begin on the first day in any plan year that the plan complies with the requirements of paragraph (b)(1)(i) of this section and must extend for a period of at least six consecutive calendar months. However, in no event may the base period begin prior to September 26, 1996 (the date of enactment of the Mental Health Parity Act (Pub. L. 104–204, 110 Stat. 2944)). (v) Rating pools. For plans that are combined in a pool for rating purposes, the calculation under this paragraph (f)(2) for each plan in the pool for the base pe- riod is based on the incurred expenditures of the pool, whether or not all the plans in the pool have participated in the pool for the entire base period. (However, only the plans that have complied with para- graph (b)(1)(i) of this section for at least six months as a member of the pool sat- isfy the requirements of this paragraph (f)(2).) Otherwise, the calculation under this paragraph (f)(2) for each plan is cal- culated by the plan administrator (or is- suer) based on the incurred expenditures of the plan. (vi) Examples.The rules of this para- graph (f)(2) are illustrated by the follow- ing examples: Example 1.(i) Agroup health plan has a plan year that is the calendar year. The plan satisfies the requirements of paragraph (b)(1)(i) of this section as of January 1, 1998. On September 15, 1998, the plan determines that $1,000,000 in claims have been incurred during the period between January 1, 1998 and June 30, 1998 and reported by August 30, 1998. The plan also determines that $100,000 in adminis- trative costs have been incurred for all benefits under the group health plan, including mental health benefits. Thus, the plan determines that its incurred expenditures for the base period are $1,100,000. The plan also determines that the claims incurred during the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section are $40,000 and that administrative expenses attributable to comply- ing with the requirements of this section are $10,000. Thus, the total amount of expenditures for the base period had the plan not been amended to comply with the requirements of paragraph (b)(1)(i) of this section are $1,050,000 ($1,100,000 - ($40,000 + $10,000) = $1,050,000). (ii) In this Example 1,the plan satisfies the re- quirements of this paragraph (f)(2) because the ap- plication of this section results in an increased cost of at least one percent under the terms of the plan ($1,100,000/$1,050,000 = 1.04762). Example 2. (i) Ahealth insurance issuer sells a group health insurance policy that is rated on a pooled basis and is sold to 30 group health plans. One of the group health plans inquires whether it qualifies for the one-percent increased cost exemp- tion. The issuer performs the calculation for the pool as a whole and determines that the application of this section results in an increased cost of 0.500 percent (for a ratio under this paragraph (f)(2) of 1.00500) for the pool. The issuer informs the re- questing plan and the other plans in the pool of the calculation. (ii) In this Example 2,none of the plans satisfy the requirements of this paragraph (f)(2) and a plan that purchases a policy not complying with the re- quirements of paragraph (b)(1)(i) of this section vio- lates the requirements of this section. In addition, an issuer that issues to any of the plans in the pool a policy not complying with the requirements of para- graph (b)(1)(i) of this section violates the require- ments of this section. Example 3.(i) Apartially insured plan is collect- ing the information to determine whether it qualifies for the exemption. The plan administrator deter- mines the incurred expenses for the base period for the self-funded portion of the plan to be $2,000,000 and the administrative expenses for the base period for the self-funded portion to be $200,000. For the insured portion of the plan, the plan administrator requests data from the insurer. For the insured por- tion of the plan, the plan’s own incurred expenses for the base period are $1,000,000 and the adminis- trative expenses for the base period are $100,000. The plan administrator determines that under the self-funded portion of the plan, the claims incurred for the base period that would have been denied under the terms of the plan absent the amendment are $0 because the self-funded portion does not cover mental health benefits and the plan’s adminis- trative costs attributable to complying with the re- quirements of this section are $1,000. The issuer de- termines that under the insured portion of the plan, the claims incurred for the base period that would have been denied under the terms of the plan absent the amendment are $25,000 and the administrative costs attributable to complying with the require- ments of this section are $1,000. Thus, the total in- curred expenditures for the plan for the base period are $3,300,000 ($2,000,000 + $200,000 + $1,000,000 + $100,000 = $3,300,000) and the total amount of expenditures for the base period had the plan not been amended to comply with the require- ments of paragraph (b)(1)(i) of this section are $3,273,000 ($3,300,000 - ($0 + $1,000 + $25,000 + $1,000) = $3,273,000). (ii) In thisExample 3, the plan does not satisfy the requirements of this paragraph (f)(2) because the application of this section does not result in an in- creased cost of at least one percent under the terms of the plan ($3,300,000/$3,273,000 = 1.00825). (3) Notice of exemption—(i) Partici- pants and beneficiaries—(A) In general. Agroup health plan must notify partici- pants and beneficiaries of the plan’s deci- sion to claim the one- percent increased cost exemption. The notice must include the following information: (1) Astatement that the plan is exempt from the requirements of this section and a description of the basis for the exemption; (2) The name and telephone number of the individual to contact for further infor- mation; (3) The plan name and plan number (PN); (4) The plan administrator’s name, ad- dress, and telephone number; (5) For single-employer plans, the plan sponsor’s name, address, and telephone number (if different from paragraph (f)(3)(i)(A)(3) of this section) and the plan sponsor’s employer identification number (EIN); (6) The effective date of the exemption; (7) The ability of participants and bene- ficiaries to contact the plan administrator to see how benefits may be affected as a result of the plan’s claim of the exemp- tion; and (8) The availability, upon request and free of charge, of a summary of the infor- mation required under paragraph (f)(4) of this section. (B) Use of summary of material reduc- tions in covered services or benefits.A plan may satisfy the requirements of para- graph (f)(3)(i)(A) of this section by pro- viding participants and beneficiaries (in accordance with paragraph (f)(3)(i)(C) of this section) with a summary of material reductions in covered services or benefits required under §2520.104b-3(d) that also includes the information of this paragraph (f)(3)(i). However, in all cases, the ex- emption is not effective until 30 days after notice has been sent. (C) Delivery.The notice described in this paragraph (f)(3)(i) is required to be provided to all participants and beneficia- ries. The notice may be furnished by any method of delivery that satisfies the re- quirements of section 104(b)(1) of ERISA (e.g., first-class mail). If the notice is pro- vided to the participant at the participant’s last known address, then the requirements of this paragraph (f)(3)(i) are satisfied with respect to the participant and all ben- eficiaries residing at that address. If a beneficiary’s last known address is differ- ent from the participant’s last known ad- dress, a separate notice is required to be provided to the beneficiary at the benefi- ciary’s last known address. (D) Example. The rules of this para- graph (f)(3)(i) are illustrated by the fol- lowing example: Example.(i) Agroup health plan has a plan year that is the calendar year and has an open enrollment 1998–3 I.R.B35January 20, 1998 period every November 1 through November 30. The plan determines on September 15 that it satis- fies the requirements of paragraph (f)(2) of this sec- tion. As part of its open enrollment materials, the plan mails, on October 15, to all participants and beneficiaries a notice satisfying the requirements of this paragraph (f)(3)(i). (ii) In thisExample,the plan has sent the notice in a manner that complies with this paragraph (f)(3)(i). (ii) Federal agencies—(A) Church plans.Achurch plan (as defined in sec- tion 414(e) of the Internal Revenue Code) claiming the exemption of this paragraph (f) for any benefit package must provide notice to the Department of the Treasury. This requirement is satisfied if the plan sends a copy, to the address designated by the Secretary in generally applicable guidance, of the notice described in para- graph (f)(3)(i) of this section identifying the benefit package to which the exemp- tion applies. (B) Group health plans subject to Part 7 of Subtitle B of Title I of ERISA.Agroup health plan subject to Part 7 of Subtitle B of Title I of ERISA, and claiming the ex- emption of this paragraph (f) for any ben- efit package, must provide notice to the Department of Labor. This requirement is satisfied if the plan sends a copy, to the address designated by the Secretary in generally applicable guidance, of the no- tice described in paragraph (f)(3)(i) of this section identifying the benefit package to which the exemption applies. (C) Nonfederal governmental plans. A group health plan that is a nonfederal gov- ernmental plan claiming the exemption of this paragraph (f) for any benefit package must provide notice to the Department of Health and Human Services (HHS). This requirement is satisfied if the plan sends a copy, to the address designated by the Secretary in generally applicable guid- ance, of the notice described in paragraph (f)(3)(i) of this section identifying the benefit package to which the exemption applies. (4) Availability of documentation. The plan (or issuer) must make available to participants and beneficiaries (or their representatives), on request and at no charge, a summary of the information on which the exemption was based. An indi- vidual who is not a participant or benefi- ciary and who presents a notice described in paragraph (f)(3)(i) of this section is considered to be a representative. Arep- resentative may request the summary of information by providing the plan a copy of the notice provided to the participant under paragraph (f)(3)(i) of this section with any individually identifiable infor- mation redacted. The summary of infor- mation must include the incurred expen- ditures, the base period, the dollar amount of claims incurred during the base period that would have been denied under the terms of the plan absent amendments re- quired to comply with paragraph (b)(1)(i) of this section, the administrative costs re- lated to those claims, and other adminis- trative costs attributable to complying with the requirements of this section. In no event should the summary of informa- tion include any individually identifiable information. (g) Special rules for group health in- surance coverage— (1) Sale of nonparity policies.An issuer may sell a policy without parity (as described in paragraph (b) of this section) only to a plan that meets the requirements of paragraphs (e) or (f) of this section. (2) Duration of exemption.After a plan meets the requirements of paragraph (f) of this section, the plan may change issuers without having to meet the requirements of paragraph (f) of this section again be- fore September 30, 2001. (h) Effective dates—(1) In general. The requirements of this section are ap- plicable for plan years beginning on or after January 1, 1998. (2) Limitation on actions. (i) Except as provided in paragraph (h)(3) of this sec- tion, no enforcement action is to be taken by the Secretary against a group health plan that has sought to comply in good faith with the requirements section 712 of the Act, with respect to a violation that occurs before the earlier of— (A) The first day of the first plan year beginning on or after April 1, 1998; or (B) January 1, 1999. (ii) Compliance with the requirements of this section is deemed to be good faith compliance with the requirements of sec- tion 712 of Part 7 of Subtitle B of Title I of ERISA. (iii) The rules of this paragraph (h)(2) are illustrated by the following examples: Example 1. (i) Agroup health plan has a plan year that is the calendar year. The plan complies with section 712 of Part 7 of Subtitle B of Title I of ERISAin good faith using assumptions inconsistent with paragraph (b)(6) of this section relating to weighted averages for categories of benefits. (ii) In this Example 1,no enforcement action may be taken against the plan with respect to a vio- lation resulting solely from those assumptions and occurring before January 1, 1999. Example 2.(i) Agroup health plan has a plan year that is the calendar year. For the entire 1998 plan year, the plan applies a $1,000,000 annual limit on medical/surgical benefits and a $100,000 annual limit on mental health benefits. (ii) In this Example 2,the plan has not sought to comply with the requirements of section 712 of the Act in good faith and this paragraph (h)(2) does not apply. (3) Transition period for increased cost exemption—(i) In general.No enforce- ment action will be taken against a group health plan that is subject to the require- ments of this section based on a violation of this section that occurs before April 1, 1998 solely because the plan claims the increased cost exemption under section 712(c)(2) of Part 7 of Subtitle B of Title I of ERISAbased on assumptions inconsis- tent with the rules under paragraph (f) of this section, provided that a plan amend- ment that complies with the requirements of paragraph (b)(1)(i) of this section is adopted and effective no later than March 31, 1998 and the plan complies with the notice requirements in paragraph (h)(3)(ii) of this section. (ii) Notice of plan’s use of transition period. (A) Agroup health plan satisfies the requirements of this paragraph (h)(3)(ii) only if the plan provides notice to the applicable federal agency and posts such notice at the location(s) where docu- ments must be made available for exami- nation by participants and beneficiaries under section 104(b)(2) of ERISAand the regulations thereunder (29 CFR 2520.104b–1(b)(3)). The notice must in- dicate the plan’s decision to use the transi- tion period in paragraph (h)(3)(i) of this section by 30 days after the first day of the plan year beginning on or after Janu- ary 1, 1998, but in no event later than March 31, 1998. For a group health plan that is a church plan, the applicable fed- eral agency is the Department of the Trea- sury. For a group health plan that is sub- ject to Part 7 of Subtitle B of Title I of ERISA, the applicable federal agency is the Department of Labor. For a group health plan that is a nonfederal govern- mental plan, the applicable federal agency is the Department of Health and Human Services. The notice must include — January 20, 1998361998–3 I.R.B. (1) The name of the plan and the plan number (PN); (2) The name, address, and telephone number of the plan administrator; (3) For single-employer plans, the name, address, and telephone number of the plan sponsor (if different from the plan administrator) and the plan sponsor’s employer identification number (EIN); (4) The name and telephone number of the individual to contact for further infor- mation; and (5) The signature of the plan adminis- trator and the date of the signature. (B) The notice must be provided at no charge to participants or their representa- tive within 15 days after receipt of a writ- ten or oral request for such notification, but in no event before the notice has been sent to the applicable federal agency. (i) Sunset.This section does not apply to benefits for services furnished on or after September 30, 2001. Signed at Washington, DC, this day of December, 1997. Olena Berg, Assistant Secretary, Pension Welfare Benefits Administration, U.S. Department of Labor. Health Care Financing Administration 45 CFR Subtitle A, Subchapter B 45 CFR Part 146 is amended as fol- lows: PART146—REQUIREMENTS FOR THE GROUPHEALTH INSURANCE MARKET 1. The authority citation for Part 146 is revised to read as follows: Authority:Secs. 2701 through 2763, 2791, and 2792 of the PHS Act (42 U.S.C. 300gg through 300gg–63, 300gg–91, and 300gg–92). 2. Anew Subpart C is added to Part 146 to read as follows: Subpart C—Requirements Related to Benefits § 146.136 Parity in the application of certain limits to mental health benefits. (a) Definitions.For purposes of this section, except where the context clearly indicates otherwise, the following defini- tions apply: Aggregate lifetime limitmeans a dollar limitation on the total amount of specified benefits that may be paid under a group health plan (or group health insurance coverage offered in connection with such plan) for an individual (or for a group of individuals considered a single unit in ap- plying this dollar limitation, such as a family or an employee plus spouse). Annual limitmeans a dollar limitation on the total amount of specified benefits that may be paid in a 12-month period under a plan (or group health insurance coverage offered in connection with such plan) for an individual (or for a group of individuals considered a single unit in ap- plying this dollar limitation, such as a family or an employee plus spouse). Medical/surgical benefits means bene- fits for medical or surgical services, as de- fined under the terms of the plan or group health insurance coverage, but does not include mental health benefits. Mental health benefitsmeans benefits for mental health services, as defined under the terms of the plan or group health insurance coverage, but does not include benefits for treatment of sub- stance abuse or chemical dependency. (b) Requirements regarding limits on benefits—(1) In general—(i) General parity requirement.Agroup health plan (or health insurance coverage offered by an issuer in connection with a group health plan) that provides both medical/ surgical benefits and mental health bene- fits must comply with paragraph (b)(2), paragraph (b)(3), or paragraph (b)(6) of this section. (ii) Exception.The rule in paragraph (b)(1)(i) of this section does not apply if a plan, or coverage, satisfies the require- ments of paragraph (e) or paragraph (f) of this section. (2) Plan with no limit or limits on less than one-third of all medical/surgical benefits.If a plan (or group health insur- ance coverage) does not include an aggre- gate lifetime or annual limit on any med- ical/surgical benefits or includes aggregate lifetime or annual limits that apply to less than one-third of all med- ical/surgical benefits, it may not impose an aggregate lifetime or annual limit, re- spectively, on mental health benefits. (3) Plan with a limit on at least two- thirds of all medical/surgical benefits. If a plan (or group health insurance cover- age) includes an aggregate lifetime or an- nual limit on at least two-thirds of all medical/surgical benefits, it must either— (i) Apply the aggregate lifetime or an- nual limit both to the medical/surgical benefits to which the limit would other- wise apply and to mental health benefits in a manner that does not distinguish be- tween the medical/surgical and mental health benefits; or (ii) Not include an aggregate lifetime or annual limit on mental health benefits that is less than the aggregate lifetime or annual limit, respectively, on the med- ical/surgical benefits. (4) Examples.The rules of paragraphs (b)(2) and (3) of this section are illus- trated by the following examples: Example 1. (i) Prior to the effective date of the mental health parity provisions, a group health plan had no annual limit on medical/surgical benefits and had a $10,000 annual limit on mental health bene- fits. To comply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the following options: (A) Eliminating the plan’s annual limit on mental health benefits; (B) Replacing the plan’s previous annual limit on mental health benefits with a $500,000 annual limit on all benefits (including medical/surgical and men- tal health benefits); and (C) Replacing the plan’s previous annual limit on mental health benefits with a $250,000 annual limit on medical/surgical benefits and a $250,000 annual limit on mental health benefits. (ii) In this Example 1,each of the three options being considered by the plan sponsor would comply with the requirements of this section because they offer parity in the dollar limits placed on medical/surgical and mental health benefits. Example 2.(i) Prior to the effective date of the mental health parity provisions, a group health plan had a $100,000 annual limit on medical/surgical in- patient benefits, a $50,000 annual limit on medical/surgical outpatient benefits, and a $100,000 annual limit on all mental health benefits. To com- ply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the fol- lowing options: (A) Replacing the plan’s previous annual limit on mental health benefits with a $150,000 annual limit on mental health benefits; and (B) Replacing the plan’s previous annual limit on mental health benefits with a $100,000 annual limit on mental health inpatient benefits and a $50,000 annual limit on mental health outpatient benefits. (ii) In this Example 2,each option under consid- eration by the plan sponsor would comply with the requirements of this section because they offer par- ity in the dollar limits placed on medical/surgical and mental health benefits. Example 3.(i) Agroup health plan that is sub- ject to the requirements of this section has no aggre- gate lifetime or annual limit for either medical/surgi- 1998–3 I.R.B37January 20, 1998 cal benefits or mental health benefits. While the plan provides medical/surgical benefits with respect to both network and out-of-network providers, it does not provide mental health benefits with respect to out-of-network providers. (ii) In thisExample 3,the plan complies with the requirements of this section because they offer par- ity in the dollar limits placed on medical/surgical and mental health benefits. Example 4.(i) Prior to the effective date of the mental health parity provisions, a group health plan had an annual limit on medical/surgical benefits and a separate but identical annual limit on mental health benefits. The plan included benefits for treatment of substance abuse and chemical dependency in its def- inition of mental health benefits. Accordingly, claims paid for treatment of substance abuse and chemical dependency were counted in applying the annual limit on mental health benefits. To comply with the parity requirements of this paragraph (b), the plan sponsor is considering each of the following options: (A) Making no change in the plan so that claims paid for treatment of substance abuse and chemical dependency continue to count in applying the annual limit on mental health benefits; (B) Amending the plan to count claims paid for treatment of substance abuse and chemical depen- dency in applying the annual limit on medical/surgi- cal benefits (rather than counting those claims in ap- plying the annual limit on mental health benefits); (C) Amending the plan to provide a new category of benefits for treatment of chemical dependency and substance abuse that is subject to a separate, lower limit and under which claims paid for treat- ment of substance abuse and chemical dependency are counted only in applying the annual limit on this separate category; and (D) Amending the plan to eliminate distinctions between medical/surgical benefits and mental health benefits and establishing an overall limit on benefits offered under the plan under which claims paid for treatment of substance abuse and chemical depen- dency are counted with medical/surgical benefits and mental health benefits in applying the overall limit. (ii) In this Example 4,the group health plan is described in paragraph (b)(3) of this section. Be- cause mental health benefits are defined in para- graph (a) of this section as excluding benefits for treatment of substance abuse and chemical depen- dency, the inclusion of benefits for treatment of sub- stance abuse and chemical dependency in applying an aggregate lifetime limit or annual limit on mental health benefits under option (A) of this Example 4 would not comply with the requirements of para- graph (b)(3) of this section. However, options (B), (C), and (D) of this Example 4would comply with the requirements of paragraph (b)(3) of this section because they offer parity in the dollar limits placed on medical/surgical and mental health benefits. (5) Determining one-third and two- thirds of all medical/surgical benefits. For purposes of this paragraph (b), the de- termination of whether the portion of medical/surgical benefits subject to a limit represents one-third or two-thirds of all medical/surgical benefits is based on the dollar amount of all plan payments for medical/surgical benefits expected to be paid under the plan for the plan year (or for the portion of the plan year after a change in plan benefits that affects the ap- plicability of the aggregate lifetime or an- nual limits). Any reasonable method may be used to determine whether the dollar amounts expected to be paid under the plan will constitute one-third or two- thirds of the dollar amount of all plan pay- ments for medical/surgical benefits. (6) Plan not described in paragraph (b)(2) or paragraph (b)(3) of this section— (i) In general.Agroup health plan (or group health insurance coverage) that is not described in paragraph (b)(2) or paragraph (b)(3) of this section, must ei- ther impose— (A) No aggregate lifetime or annual limit, as appropriate, on mental health benefits; or (B) An aggregate lifetime or annual limit on mental health benefits that is no less than an average limit for medical/sur- gical benefits calculated in the following manner. The average limit is calculated by taking into account the weighted aver- age of the aggregate lifetime or annual limits, as appropriate, that are applicable to the categories of medical/surgical ben- efits. Limits based on delivery systems, such as inpatient/outpatient treatment, or normal treatment of common, low-cost conditions (such as treatment of normal births), do not constitute categories for purposes of this paragraph (b)(6)(i)(B). In addition, for purposes of determining weighted averages, any benefits that are not within a category that is subject to a separately-designated limit under the plan are taken into account as a single separate category by using an estimate of the upper limit on the dollar amount that a plan may reasonably be expected to incur with re- spect to such benefits, taking into account any other applicable restrictions under the plan. (ii) Weighting.For purposes of this paragraph (b)(6), the weighting applica- ble to any category of medical/surgical benefits is determined in the manner set forth in paragraph (b)(5) of this section for determining one-third or two-thirds of all medical/surgical benefits. (iii) Examples.The rules of this para- graph (b)(6) are illustrated by the follow- ing example: Example.(i) Agroup health plan that is subject to the requirements of this section includes a $100,000 annual limit on medical/surgical benefits related to cardio-pulmonary diseases. The plan does not include an annual limit on any other category of medical/surgical benefits. The plan determines that 40% of the dollar amount of plan payments for med- ical/surgical benefits are related to cardio-pul- monary diseases. The plan determines that $1,000,000 is a reasonable estimate of the upper limit on the dollar amount that the plan may incur with respect to the other 60% of payments for med- ical/surgical benefits. (ii) In this Example, the plan is not described in paragraph (b)(3) of this section because there is not one annual limit that applies to at least two-thirds of all medical/surgical benefits. Further, the plan is not described in paragraph (b)(2) of this section because more than one-third of all medical/surgical benefits are subject to an annual limit. Under this paragraph (b)(6), the plan sponsor can choose either to include no annual limit on mental health benefits, or to in- clude an annual limit on mental health benefits that is not less than the weighted average of the annual limits applicable to each category of medical/surgi- cal benefits. In this example, the minimum weighted average annual limit that can be applied to mental health benefits is $640,000 (40% 3 $100,000 + 60% 3$1,000,000 = $640,000). (c) Rule in the case of separate benefit packages. If a group health plan offers two or more benefit packages, the re- quirements of this section, including the exemption provisions in paragraph (f) of this section, apply separately to each ben- efit package. Examples of a group health plan that offers two or more benefit pack- ages include a group health plan that of- fers employees a choice between indem- nity coverage or HMO coverage, and a group health plan that provides one bene- fit package for retirees and a different benefit package for current employees. (d) Applicability—(1) Group health plans.The requirements of this section apply to a group health plan offering both medical/surgical benefits and mental health benefits regardless of whether the mental health benefits are administered separately under the plan. (2) Health insurance issuers.The re- quirements of this section apply to a health insurance issuer offering health in- surance coverage for both medical/surgi- cal benefits and mental health benefits in connection with a group health plan. (3) Scope.This section does not— (i) Require a group health plan (or health insurance issuer offering coverage in connection with a group health plan) to provide any mental health benefits; or (ii) Affect the terms and conditions (in- cluding cost sharing, limits on the number January 20, 1998381998–3 I.R.B. of visits or days of coverage, require- ments relating to medical necessity, re- quiring prior authorization for treatment, or requiring primary care physicians’re- ferrals for treatment) relating to the amount, duration, or scope of the mental health benefits under the plan (or cover- age) except as specifically provided in paragraph (b) of this section. (e) Small employer exemption—(1) In general.The requirements of this section do not apply to a group health plan (or health insurance issuer offering coverage in connection with a group health plan) for a plan year of a small employer. For purposes of this paragraph (e), the term small employermeans, in connection with a group health plan with respect to a cal- endar year and a plan year, an employer who employed an average of at least two but not more than 50 employees on busi- ness days during the preceding calendar year and who employs at least two em- ployees on the first day of the plan year. See regulations at § 146.145(a), which provide that this section (and certain other sections) does not apply to any group health plan (and health insurance issuer offering coverage in connection with a group health plan) for any plan year if, on the first day of the plan year, the plan has fewer than two participants who are cur- rent employees. (2) Rules in determining employer size. For purposes of paragraph (e)(1) of this section— (i) All persons treated as a single em- ployer under subsections (b), (c), (m), and (o) of section 414 of the Internal Revenue Code of 1986 (26 U.S.C. 414) are treated as one employer; (ii) If an employer was not in existence throughout the preceding calendar year, whether it is a small employer is deter- mined based on the average number of employees the employer reasonably ex- pects to employ on business days during the current calendar year; and (iii) Any reference to an employer for purposes of the small employer exemp- tion includes a reference to a predecessor of the employer. (f) Increased cost exemption—(1) In general.Agroup health plan (or health insurance coverage offered in connection with a group health plan) is not subject to the requirements of this section if the re- quirements of this paragraph (f) are satis- fied. If a plan offers more than one bene- fit package, this paragraph (f) applies sep- arately to each benefit package. Except as provided in paragraph (h) of this sec- tion, a plan must comply with the require- ments of paragraph (b)(1)(i) of this sec- tion for the first plan year beginning on or after January 1, 1998, and must continue to comply with the requirements of para- graph (b)(1)(i) of this section until the plan satisfies the requirements in this paragraph (f). In no event is the exemp- tion of this paragraph (f) effective until 30 days after the notice requirements in para- graph (f)(3) of this section are satisfied. If the requirements of this paragraph (f) are satisfied with respect to a plan, the ex- emption continues in effect (at the plan’s discretion) until September 30, 2001, even if the plan subsequently purchases a different policy from the same or a differ- ent issuer and regardless of any other changes to the plan’s benefit structure. (2) Calculation of the one-percent in- crease—(i) Ratio.Agroup health plan (or group health insurance coverage) sat- isfies the requirements of this paragraph (f)(2) if the application of paragraph (b)(1)(i) of this section to the plan (or to such coverage) results in an increase in the cost under the plan (or for such cover- age) of at least one percent. The applica- tion of paragraph (b)(1)(i) of this section results in an increased cost of at least one percent under a group health plan (or for such coverage) only if the ratio below equals or exceeds 1.01000. The ratio is determined as follows: (A) The incurred expenditures during the base period, divided by, (B) The incurred expenditures during the base period, reduced by — (1) The claims incurred during the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section, and (2) Administrative expenses attribut- able to complying with the requirements of this section. (ii) Formula. The ratio of paragraph (f)(2)(i) is expressed mathematically as follows: IE ≥1.01000 IE – (CE + AE) (A) IEmeans the incurred expendi- tures during the base period. (B) CEmeans the claims incurred dur- ing the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section. (C) AEmeans administrative costs re- lated to claims in CEand other adminis- trative costs attributable to complying with the requirements of this section. (iii) Incurred expenditures.Incurred expendituresmeans actual claims in- curred during the base period and re- ported within two months following the base period, and administrative costs for all benefits under the group health plan, including mental health benefits and med- ical/surgical benefits, during the base pe- riod. Incurred expenditures do not in- clude premiums. (iv) Base period.Base period means the period used to calculate whether the plan may claim the one-percent increased cost exemption in this paragraph (f). The base period must begin on the first day in any plan year that the plan complies with the requirements of paragraph (b)(1)(i) of this section and must extend for a period of at least six consecutive calendar months. However, in no event may the base period begin prior to September 26, 1996 (the date of enactment of the Mental Health Parity Act (Pub. L. 104–204, 110 Stat. 2944)). (v) Rating pools.For plans that are combined in a pool for rating purposes, the calculation under this paragraph (f)(2) for each plan in the pool for the base pe- riod is based on the incurred expenditures of the pool, whether or not all the plans in the pool have participated in the pool for the entire base period. (However, only the plans that have complied with para- graph (b)(1)(i) of this section for at least six months as a member of the pool sat- isfy the requirements of this paragraph (f)(2).) Otherwise, the calculation under this paragraph (f)(2) for each plan is cal- culated by the plan administrator (or is- suer) based on the incurred expenditures of the plan. (vi) Examples.The rules of this para- graph (f)(2) are illustrated by the follow- ing examples: Example 1.(i) Agroup health plan has a plan year that is the calendar year. The plan satisfies the requirements of paragraph (b)(1)(i) of this section as of January 1, 1998. On September 15, 1998, the plan determines that $1,000,000 in claims have been 1998–3 I.R.B39January 20, 1998 incurred during the period between January 1, 1998 and June 30, 1998 and reported by August 30, 1998. The plan also determines that $100,000 in adminis- trative costs have been incurred for all benefits under the group health plan, including mental health benefits. Thus, the plan determines that its incurred expenditures for the base period are $1,100,000. The plan also determines that the claims incurred during the base period that would have been denied under the terms of the plan absent plan amendments required to comply with this section are $40,000 and that administrative expenses attributable to comply- ing with the requirements of this section are $10,000. Thus, the total amount of expenditures for the base period had the plan not been amended to comply with the requirements of paragraph (b)(1)(i) of this section are $1,050,000 ($1,100,000 – ($40,000 + $10,000) = $1,050,000). (ii) In this Example 1,the plan satisfies the re- quirements of this paragraph (f)(2) because the ap- plication of this section results in an increased cost of at least one percent under the terms of the plan ($1,100,000/$1,050,000 = 1.04762). Example 2.(i) Ahealth insurance issuer sells a group health insurance policy that is rated on a pooled-basis and is sold to 30 group health plans. One of the group health plans inquires whether it qualifies for the one percent increased cost exemp- tion. The issuer performs the calculation for the pool as a whole and determines that the application of this section results in an increased cost of 0.500 percent (for a ratio under this paragraph (f)(2) of 1.00500) for the pool. The issuer informs the re- questing plan and the other plans in the pool of the calculation. (ii) In thisExample 2, none of the plans satisfy the requirements of this paragraph (f)(2) and a plan that purchases a policy not complying with the re- quirements of paragraph (b)(1)(i) of this section vio- lates the requirements of this section. In addition, an issuer that issues to any of the plans in the pool a policy not complying with the requirements of para- graph (b)(1)(i) of this section violates the require- ments of this section. Example 3.(i) Apartially-insured plan is col- lecting the information to determine whether it qual- ifies for the exemption. The plan administrator de- termines the incurred expenses for the base period for the self-funded portion of the plan to be $2,000,000 and the administrative expenses for the base period for the self-funded portion to be $200,000. For the insured portion of the plan, the plan administrator requests data from the insurer. For the insured portion of the plan, the plan’s own incurred expenses for the base period are $1,000,000 and the administrative expenses for the base period are $100,000. The plan administrator determines that under the self-funded portion of the plan, the claims incurred for the base period that would have been denied under the terms of the plan absent the amendment are $0 because the self-funded portion does not cover mental health benefits and the plan’s administrative costs attributable to complying with the requirements of this section are $1,000. The is- suer determines that under the insured portion of the plan, the claims incurred for the base period that would have been denied under the terms of the plan absent the amendment are $25,000 and the adminis- trative costs attributable to complying with the re- quirements of this section are $1,000. Thus, the total incurred expenditures for the plan for the base period are $3,300,000 ($2,000,000 + $200,000 + $1,000,000 + $100,000 = $3,300,000) and the total amount of expenditures for the base period had the plan not been amended to comply with the require- ments of paragraph (b)(1)(i) of this section are $3,273,000 ($3,300,000 - ($0 + $1,000 + $25,000 + $1,000) = $3,273,000). (ii) In this Example 3,the plan does not satisfy the requirements of this paragraph (f)(2) because the application of this section does not result in an in- creased cost of at least one percent under the terms of the plan ($3,300,000/$3,273,000 = 1.00825). (3) Notice of exemption—(i) Partici- pants and beneficiaries—(A) In general. Agroup health plan must notify partici- pants and beneficiaries of the plan’s deci- sion to claim the one percent increased cost exemption. The notice must include the following information: (1) Astatement that the plan is exempt from the requirements of this section and a description of the basis for the exemp- tion. (2) The name and telephone number of the individual to contact for further infor- mation. (3)The plan name and plan number (PN). (4) The plan administrator’s name, ad- dress, and telephone number. (5) For single-employer plans, the plan sponsor’s name, address, and telephone number (if different from paragraph (f)(3)(i)(A)(3) of this section) and the plan sponsor’s employer identification number (EIN). (6) The effective date of such exemp- tion. (7) The ability of participants and bene- ficiaries to contact the plan administrator to see how benefits may be affected as a result of the plan’s election of the exemp- tion. (8) The availability, upon request and free of charge, of a summary of the infor- mation required under paragraph (f)(4) of this section. (B) Use of summary of material reduc- tions in covered services or benefits. A plan may satisfy the requirements of para- graph (f)(3)(i)(A) by providing partici- pants and beneficiaries (in accordance with paragraph (f)(3)(i)(C)) with a sum- mary of material reductions in covered services or benefits consistent with De- partment of Labor regulations at 29 CFR 2520.104b–3(d) that also includes the in- formation of this paragraph (f)(3)(i). However, in all cases, the exemption is not effective until 30 days after notice has been sent. (C) Delivery. The notice described in this paragraph (f)(3)(i) is required to be provided to all participants and beneficia- ries. The notice may be furnished by any method of delivery that satisfies the re- quirements of section 104(b)(1) of ERISA (29 U.S.C. 1024(b)(1)) (e.g., first-class mail). If the notice is provided to the par- ticipant at the participant’s last known ad- dress, then the requirements of this para- graph (f)(3)(i) are satisfied with respect to the participant and all beneficiaries resid- ing at that address. If a beneficiary’s last known address is different from the par- ticipant’s last known address, a separate notice is required to be provided to the beneficiary at the beneficiary’s last known address. (D) Example.The rules of this para- graph (f)(3)(i) are illustrated by the fol- lowing example: Example.(i) Agroup health plan has a plan year that is the calendar year and has an open enrollment period every November 1 through November 30. The plan determines on September 15 that it satis- fies the requirements of paragraph (f)(2) of this sec- tion. As part of its open enrollment materials, the plan mails, on October 15, to all participants and beneficiaries a notice satisfying the requirements of this paragraph (f)(3)(i). (ii) In this Example,the plan has sent the notice in a manner that complies with this paragraph (f)(3)(i). (ii) Federal agencies—(A) Church plans.Achurch plan (as defined in sec- tion 414(e) of the Internal Revenue Code) claiming the exemption of this paragraph (f) for any benefit package must provide notice to the Department of the Treasury. This requirement is satisfied if the plan sends a copy, to the address designated by the Secretary in generally applicable guidance, of the notice described in para- graph (f)(3)(i) of this section identifying the benefit package to which the exemp- tion applies. (B) Group health plans subject to Part 7 of Subtitle B of Title I of ERISA.Agroup health plan subject to Part 7 of Subtitle B of Title I of ERISA, and claiming the ex- emption of this paragraph (f) for any ben- efit package, must provide notice to the Department of Labor. This requirement is satisfied if the plan sends a copy, to the address designated by the Secretary in generally applicable guidance, of the no- tice described in paragraph (f)(3)(i) of this January 20, 1998401998–3 I.R.B. section identifying the benefit package to which the exemption applies. (C) Non-Federal governmental plans. Agroup health plan that is a non-Federal governmental plan claiming the exemp- tion of this paragraph (f) for any benefit package must provide notice to the De- partment of Health and Human Services (HHS). This requirement is satisfied if the plan sends a copy, to the address des- ignated by the Secretary in generally ap- plicable guidance, of the notice described in paragraph (f)(3)(i) of this section iden- tifying the benefit package to which the exemption applies. (4)Availability of documentation.The plan (or issuer) must make available to participants and beneficiaries (or their representatives), on request and at no charge, a summary of the information on which the exemption was based. An indi- vidual who is not a participant or benefi- ciary and who presents a notice described in paragraph (f)(3)(i) of this section is considered to be a representative. Arep- resentative may request the summary of information by providing the plan a copy of the notice provided to the participant under paragraph (f)(3)(i) of this section with any individually identifiable infor- mation redacted. The summary of infor- mation must include the incurred expen- ditures, the base period, the dollar amount of claims incurred during the base period that would have been denied under the terms of the plan absent amendments re- quired to comply with paragraph (b)(1)(i) of this section, the administrative costs re- lated to those claims, and other adminis- trative costs attributable to complying with the requirements for the exemption. In no event should the summary of infor- mation include any individually identifi- able information. (g) Special rules for group health in- surance coverage—(1) Sale of nonparity policies.An issuer may sell a policy without parity (as described in paragraph (b) of this section) only to a plan that meets the requirements of paragraph (e) or paragraph (f) of this section. (2) Duration of exemption.After a plan meets the requirements of paragraph (f) of this section, the plan may change issuers without having to meet the requirements of paragraph (f) of this section again be- fore September 30, 2001. (h) Effective dates—(1) In general. The requirements of this section are ap- plicable for plan years beginning on or after January 1, 1998. (2) Limitation on actions.(i) Except as provided in paragraph (h)(3) of this sec- tion, no enforcement action is to be taken by the Secretary against a group health plan that has sought to comply in good faith with the requirements of section 2705 of the PHS Act, with respect to a vi- olation that occurs before the earlier of — (A) The first day of the first plan year beginning on or after April 1, 1998; or (B) January 1, 1999. (ii) Compliance with the requirements of this section is deemed to be good faith compliance with the requirements of sec- tion 2705 of the PHS Act. (iii) The rules of this paragraph (h)(2) are illustrated by the following examples: Example 1. (i) Agroup health plan has a plan year that is the calendar year. The plan complies with section 2705 of the PHS Act in good faith using assumptions inconsistent with paragraph (b)(6) of this section relating to weighted averages for cate- gories of benefits. (ii) In this Example 1,no enforcement action may be taken against the plan with respect to a vio- lation resulting solely from those assumptions and occurring before January 1, 1999. Example 2. (i) Agroup health plan has a plan year that is the calendar year. For the entire 1998 plan year, the plan applies a $1,000,000 annual limit on medical/surgical benefits and a $100,000 annual limit on mental health benefits. (ii) In this Example 2,the plan has not sought to comply with the requirements of section 2705 of the PHS Act in good faith and this paragraph (h)(2) does not apply. (3) Transition period for increased cost exemption—(i) In general.No enforce- ment action will be taken against a group health plan that is subject to the require- ments of this section based on a violation of this section that occurs before April 1, 1998 solely because the plan claims the in- creased cost exemption under section 2705(c)(2) of the PHS Act based on as- sumptions inconsistent with the rules under paragraph (f) of this section, provided that a plan amendment that complies with the re- quirements of paragraph (b)(1)(i) of this section is adopted and effective no later than March 31, 1998 and the plan complies with the notice requirements in paragraph (h)(3)(ii) of this section. (ii) Notice of plan’s use of transition period.(A) Agroup health plan satisfies the requirements of this paragraph (h)(3)(ii) only if the plan provides notice to the applicable federal agency and posts the notice at the location(s) where docu- ments must be made available for exami- nation by participants and beneficiaries under section 104(b)(2) of ERISAand the regulations thereunder (29 CFR 2520.104b–1(b)(3)). The notice must in- dicate the plan’s decision to use the transi- tion period in paragraph (h)(3)(i) of this section by 30 days after the first day of the plan year beginning on or after Janu- ary 1, 1998, but in no event later than March 31, 1998. For a group health plan that is a church plan, the applicable fed- eral agency is the Department of the Trea- sury. For a group health plan that is sub- ject to Part 7 of Subtitle B of Title I of ERISA, the applicable federal agency is the Department of Labor. For a group health plan that is a nonfederal govern- mental plan, the applicable federal agency is the Department of Health and Human Services. The notice must include — (1) The name of the plan and the plan number (PN); (2) The name, address, and telephone number of the plan administrator; (3) For single-employer plans, the name, address, and telephone number of the plan sponsor (if different from the plan administrator) and the plan sponsor’s employer identification number (EIN); (4) The name and telephone number of the individual to contact for further infor- mation; and (5) The signature of the plan adminis- trator and the date of the signature. (B) The notice must be provided at no charge to participants or their representa- tive within 15 days after receipt of a writ- ten or oral request for such notification, but in no event before the notice has been sent to the applicable federal agency. (i) Sunset.This section does not apply to benefits for services furnished on or after September 30, 2001. Authority:Secs. 2741 through 2763, 2791, and 2792 of the PHS Act, 42 U.S.C. 300gg–41 through 300gg–63, 300gg–91, and 300gg–92. Nancy-Ann Min DeParle, Administrator, Health Care Financing Administration. Donna E. Shalala, Secretary. (Filed by the Office of the Federal Register on De- cember 19, 1997, 8:45 a.m., and published in the issue of the Federal Register for December 22, 1997, 62 F.R. 66932) 1998–3 I.R.B41January 20, 1998 January 20, 1998421998–3 I.R.B. Cash or Deferred Arrangements; Nondiscrimination Notice 98–1 I. PURPOSE This notice provides guidance and tran- sition relief relating to recent statutory amendments to the nondiscrimination rules under §401(k) and §401(m) of the Internal Revenue Code. The rules applic- able to qualified cash or deferred arrange- ments under §401(k) and matching and employee contributions under §401(m) were amended by the Small Business Job Protection Act of 1996 (SBJPA), Pub. L. 104–188. Specifically, this notice provides guid- ance on •The election to use the current year testing method. •The use of qualified nonelective con- tributions (QNCs) and qualified matching contributions (QMACs) under the prior year testing method. •The application of the first plan year rule under the prior year testing method. •The impact of certain plan population changes under the prior year testing method. •Achange from the current year test- ing method to the prior year testing method, including related transition relief. •Plan amendments needed to reflect the testing method of a plan, includ- ing the application of the remedial amendment period under §401(b). II. BACKGROUND A. SBJPAAmendments to §401(k) and §401(m) Under §401(k) and §401(m), the ac- tual deferral percentage (ADP) and the actual contribution percentage (ACP) of highly compensated employees (HCEs) are compared with those of nonhighly compensated employees (NHCEs). Sec- tion 1433(c) of SBJPAamended §401(k)(3)(A) and §401(m)(2)(A), ef- fective for plan years beginning after De- cember 31, 1996, to provide for the use of prior year data in determining the ADP and ACPfor NHCEs, while continuing to provide for the use of current year data for HCEs. Alternatively, an employer may elect to use current year data for deter- mining the ADPand ACPfor both HCEs and NHCEs, but the statute provides that this election may be changed only as pro- vided by the Secretary. Section 1433(d) of SBJPAamended §401(k)(3) and §401(m)(3) to provide a special rule for determining the ADPand ACPfor NHCEs for the first plan year of a plan (other than a successor plan) where the prior year testing method is used. B. Guidance on the SBJPA Amendments Notice 97–2, 1997–2 I.R.B. 22, pro- vides guidance on determining the indi- viduals who are taken into account in computing the ADPor ACPfor NHCEs for the prior year under the prior year test- ing method. The guidance provides tran- sition relief to allow plans using the cur- rent year testing method for the 1997 testing year to change to the prior year testing method for the 1998 testing year without obtaining approval from the In- ternal Revenue Service. The notice also provides rules for distributions of excess contributions and excess aggregate contri- butions. Notice 97–2 states that Treasury and the Service will issue guidance regarding the conditions under which employers that elect to use current year data for the 1998 or a later plan year may change that election and use prior year testing for sub- sequent plan years. Notice 97–2 also re- quested comments concerning (i) the use of QNCs and QMACs in computing the prior year’s ADPfor NHCEs, including methods of preventing inappropriate dou- ble counting; and (ii) the appropriate de- termination of the prior year’s ADPfor NHCEs when the group of employees tested is significantly different in the cur- rent year than in the prior year. After con- sideration of the comments received, this notice provides guidance on these issues. Rev. Proc. 97–41, 1997–33 I.R.B. 51, provides guidance to sponsors of plans that are qualified under §401(a) with re- spect to the date by which they must adopt amendments to comply with changes in the law, including a remedial amendment period for amendments to re- flect changes to the qualification require- ments made by SBJPA. C. Definitions If a term that is used in this notice is de- fined in the regulations under §401(k) or §401(m), then the definition under these regulations applies for purposes of this notice. For example, “plan” as used in this notice means plan as defined in §1.401(k)–1(g)(11) of the Income Tax Regulations. In addition, for purposes of this notice, the “testing year” is the plan year for which the ADPor ACPfor HCEs is being tested; the “prior year” is the plan year immediately preceding the testing year. If the plan uses data from the testing year in determining the ADPor ACPfor NHCEs, it is using the “current year testing method;” if the plan uses data from the prior year in determining the ADPor ACP for NHCEs, it is using the “prior year test- ing method.” Sections Vand VI of this notice pro- vide additional definitions used in apply- ing the first plan year rule and definitions used in the rules relating to changes in the group of eligible employees when a plan uses the prior year testing method. D. Effect of Statutory Changes on Regulations Because of the amendments made to §401(k) and §401(m), certain portions of §1.401(k)–1 and §§1.401(m)–1 and 1.401(m)–2 no longer reflect current law. This notice provides guidance on a limited number of issues relating to the use of the prior year testing method and relating to a change in testing method. The regulations shall continue in force to the extent that they are not inconsistent with the Code, as amended, and subsequent guidance, in- cluding Notice 97–2 and this notice. III. USE OFCURRENTYEAR TESTING METHOD As provided under §401(k)(3)(A) and §401(m)(2)(A), an employer may elect to Part III. Administrative, Procedural, and Miscellaneous 1998–3 I.R.B43January 20, 1998 use the current year testing method for a plan in lieu of the prior year testing method. Aplan using the prior year test- ing method may adopt the current year testing method for any subsequent testing year. Notification to or filing with the Service of an election to use the current year testing method is not required in order for the election to be valid. How- ever, as provided in section IX of this no- tice, the plan document governing the plan must reflect whether the plan uses the current year testing method or the prior year testing method for a testing year. Aplan that uses the current year testing method for a testing year may not be per- missively aggregated under §1.410(b)– 7(d) with a plan that uses the prior year testing method for that testing year. IV. USE OFQNCs AND QMACs UNDER PRIOR YEAR TESTING METHOD Section 401(k)(3)(D) and §401(m)(3) provide that an employer may take into account QNCs and QMACs in calculating the ADP, and QNCs in calculating the ACP, as provided by the Secretary. Aplan may continue to take QNCs and QMACs into account under the prior year testing method, subject to the limitations set forth in section VII.B. of this notice. A. Timing of Contribution of QNCs and QMACs In order to be taken into account in the calculation of the ADPor ACPfor a year under the prior year testing method, a QNC or QMAC must be allocated as of a date within the year and must actually be paid to the trust no later than the end of the 12-month period following the end of the year to which the contribution relates. See §§1.401(k)–1(b)(4)(i)(A) and (b)(5)(v) and §§1.401(m)–1(b)(4)(ii) and (b)(5)(iv). Consequently, under the prior year testing method, in order to be taken into account in calculating the ADPor ACPfor NHCEs for the prior year, a QNC or QMAC must be contributed by the end of the testing year. Thus, for example, if the prior year testing method is used for the 1998 testing year, QNCs that are allo- cated to the accounts of NHCEs for the 1997 plan year (i.e., the prior year) must be contributed to the plan by the end of the 1998 plan year in order to be treated as elective contributions for purposes of the ADPtest for the 1998 testing year. By contrast, in order to be taken into account in calculating the ADPor ACPfor HCEs for the 1998 testing year, a QNC or QMAC must be contributed by the end of the 1999 plan year. It should be noted that §1.415–6(b)- (7)(ii) provides that, for purposes of satis- fying §415, employer contributions shall not be deemed credited to a participant’s account for a particular limitation year unless the contributions are actually made to the plan no later than 30 days after the end of the period described in §404(a)(6) applicable to the taxable year with or within which the particular limitation year ends. Thus, contributions made after the date described in §1.415–6(b)(7)(ii) are treated as annual additions for the next §415 limitation year. Accordingly, under either the prior year testing method or the current year testing method, a violation of §415(c) might occur if QNCs or QMACs are contributed after the date described in §1.415–6(b)(7)(ii). B. Nondiscrimination Testing of QNCs under the Prior Year Testing Method Section 1.401(k)-1(b)(5) provides that (i) the amount of nonelective contribu- tions, including those QNCs treated as elective contributions for purposes of the ADPtest, and (ii) the amount of nonelec- tive contributions, excluding those QNCs treated as elective contributions for pur- poses of the ADPtest, must each satisfy the requirements of §401(a)(4). Under §1.401(m)-1(b)(5), a similar rule applies to QNCs treated as matching contribu- tions for purposes of the ACPtest. These nondiscrimination requirements continue to apply to plans that use the prior year testing method. This is true even though the QNCs allocated to the HCEs and NHCEs in a single plan year are taken into account for ADPand ACP testing in different testing years. Accord- ingly, QNCs allocated to the accounts of NHCEs and HCEs for the same plan year will be subject to the requirements of §401(a)(4) for that plan year; however, QNCs allocated to the accounts of HCEs will be taken into account for ADPor ACPtesting in the plan year for which they are allocated, while QNCs allocated to the accounts of NHCEs will not be taken into account in determining the per- mitted ADPor ACPfor HCEs until the following plan year. V. FIRSTPLAN YEAR RULE UNDER PRIOR YEAR TESTING METHOD Section 401(k)(3)(E) provides that, for the first plan year of any plan (other than a successor plan) that uses the prior year testing method, the ADPfor NHCEs for the prior year is 3%, or, if the employer elects, is the ADPfor NHCEs for that first plan year. For this purpose, the “first plan year” of any plan is the first year in which the plan, within the meaning of §414(l), is or includes a section401(k) plan (i.e., the first year a plan provides for elective con- tributions described in §1.401(k)–1(g)- (3)). However, a plan does not have a first plan year if for such plan year the plan is aggregated under §1.401(k)–1(g)11) with any other plan that was or that included a section401(k) plan in the prior year. Section 401(m)(3) provides that rules similar to the rules of §401(k)(3)(E) shall apply for purposes of the ACPtest. For purposes of the ACPtest, the “first plan year” of any plan is the first year in which a plan, within the meaning of §414(l), is or includes a section 401(m) plan (i.e., the first year a plan provides for employee contributions described in §1.401(m)– 1(f)(6) or matching contributions de- scribed in §1.401(m)–1(f)(12), or both). However, a plan does not have a first plan year if for such plan year the plan is ag- gregated for purposes of §1.401(m)– 1(g)(14) with any other plan that was or that included a section401(m) plan in the prior year. For purposes of this notice, a plan is a “successor plan” if 50% or more of the el- igible employees for the first plan year were eligible employees under another section 401(k) plan (or section 401(m) plan, as applicable) maintained by the employer in the prior year. For example, in 1998, Employer H sponsors Plan T, a section 401(k) plan. In 1999, Employer H establishes Plan U, also a section401(k) plan, which had 200 eligible employees, including 100 employees who were eligi- ble employees under Plan Tin 1998. Plan U is a successor plan. January 20, 1998441998–3 I.R.B. If a plan (other than a successor plan) uses the prior year testing method and for its first plan year the plan determines the ADPor ACPfor NHCEs for the prior plan year using the ADPor ACPfor NHCEs for that first plan year (in lieu of 3%), then the use of the prior year testing method in the next testing year is not treated as a change in testing method. Such a plan would not be subject to the limitations on double counting described in section VII.B. for that next testing year. If a successor plan uses the prior year test- ing method for its first plan year, the ADP and ACPfor NHCEs for the prior year are determined under the rules in section Vof this notice. VI. CHANGES IN THE GROUPOF ELIGIBLE NHCEs WHERE PLAN USES PRIOR YEAR TESTING METHOD A. General Rule: Disregard Changes in the Group of NHCEs Except as provided in section VI.B. and C., below, under the prior year testing method, the ADPor ACPfor NHCEs for the prior year under a plan is determined without regard to changes in the group of NHCEs who are eligible employees under the plan in the testing year. Thus, under the prior year testing method, the prior year ADPor ACPfor NHCEs is used even though some NHCEs may have first be- come eligible employees under the plan in the testing year because they meet exist- ing plan eligibility requirements, and even though individuals who were eligi- ble employees under the plan and NHCEs in the prior year are no longer employed by the employer or have become HCEs in the testing year. B. Exception for Plan Coverage Changes If a plan results from, or is otherwise affected by, a plan coverage change that becomes effective during the testing year, then the ADPand ACPfor NHCEs for the prior year under the plan is the weighted average of the ADPs for the prior year subgroups and the weighted average of the ACPs for the prior year subgroups, re- spectively. C. Optional Rule for Minor Plan Coverage Changes If a plan results from, or is otherwise affected by, a plan coverage change, and 90% or more of the total number of NHCEs from all prior year subgroups are from a single prior year subgroup, then in determining the ADPor ACPfor NHCEs for the prior year under the plan, an em- ployer may elect to use the ADPand ACP for NHCEs for the prior year of the plan under which that single prior year sub- group was eligible, in lieu of using the weighted averages described in section VI.B., above. D. Definitions For purposes of this notice: 1.“Plan coverage change” means a change in the group or groups of eligible employees under a plan on account of (a) the establishment or amendment of a plan, (b) a plan merger, consolidation, or spinoff under §414(l), (c) a change in the way plans within the meaning of §414(l) are combined or separated for purposes of §1.401(k)–1(g)(11) (e.g., permissively aggregating plans not previously aggre- gated under §1.410(b)–7(d), or ceasing to permissively aggregate plans under §1.410(b)–7(d)), or (d) a combination of any of the foregoing. 2.“Prior year subgroup” means all NHCEs for the prior year who, in the prior year, were eligible employees under a specific section 401(k) plan (or, in the case of the ACPtest, a specific section 401(m) plan) maintained by the employer and who would have been eligible em- ployees in the prior year under the plan being tested if the plan coverage change had first been effective as of the first day of the prior year instead of first being ef- fective during the testing year. 3.“Weighted average of the ADPs for the prior year subgroups” and “weighted average of the ACPs for the prior year subgroups” mean the sum, for all prior year subgroups, of the adjusted ADPs and adjusted ACPs, respectively. 4.“Adjusted ADP” and “adjusted ACP” with respect to a prior year sub- group mean the respective ADPand ACP for NHCEs for the prior year of the spe- cific plan under which the members of the prior year subgroup were eligible employ- ees, multiplied by a fraction, the numera- tor of which is the number of NHCEs in the prior year subgroup and the denomi- nator of which is the total number of NHCEs in all prior year subgroups. E. Examples The requirements of this section VI are illustrated by the following examples: Example 1: (i) Employer B maintains two plans, Plan N and Plan P, each of which includes a section401(k) plan. The plans were not permissively aggregated under §1.410(b)–7(d) for the 1998 testing year. Both plans use the prior year testing method. Plan N had 300 eligible employ- ees who were NHCEs for 1998, and their ADPfor that year was 6%. Plan Phad 100 eligible employees who were NHCEs for 1998, and the ADPfor those NHCEs for that plan was 4%. Plan N and Plan P are permissively aggregated under §1.410(b)–7(d) for the 1999 plan year. (ii) The permissive aggregation of Plan N and Plan Pfor the 1999 testing year under §1.410(b)–7(d) is a plan coverage change that results in treating the plans as one plan (Plan NP) for purposes of §1.401(k)–1(g)(11). Therefore, the prior year ADPfor NHCEs under Plan NPfor the 1999 testing year is the weighted aver- age of the ADPs for the prior year sub- groups. (iii) The first step in determining the weighted average of the ADPs for the prior year subgroups is to identify the prior year subgroups. With respect to the 1999 testing year, an employee is a mem- ber of a prior year subgroup if the em- ployee (A) was an NHCE of Employer B for the 1998 plan year, (B) was an eligible employee for the 1998 plan year under any section 401(k) plan maintained by Employer B, and (C) would have been an eligible employee in the 1998 plan year under Plan NPif Plan N and Plan Phad been permissively aggregated under §1.410(b)–7(d) for that plan year. The NHCEs who were eligible employees under separate section401(k) plans for the 1998 plan year comprise separate 1998–3 I.R.B45January 20, 1998 prior year subgroups. Thus, there are two prior year subgroups under Plan NPfor the 1999 testing year: the 300 NHCEs who were eligible employees under Plan N for the 1998 plan year and the 100 NHCEs who were eligible employees under Plan Pfor the 1998 plan year. (iv) The weighted average of the ADPs for the prior year subgroups is the sum of: (A) the adjusted ADPwith respect to the prior year subgroup that consists of the NHCEs who were eligible employees under Plan N, and (B) the adjusted ADP with respect to the prior year subgroup that consists of the NHCEs who were eli- gible employees under Plan P. The ad- justed ADPfor the prior year subgroup that consists of the NHCEs who were eli- gible employees under Plan N is 4.5%, calculated as follows: 6% (the ADPfor the NHCEs under Plan N for the prior year) x 300/400 (the number of NHCEs in that prior year subgroup divided by the total number of NHCEs in all prior year subgroups), which equals 4.5%. The ad- justed ADPfor the prior year subgroup that consists of the NHCEs who were eli- gible employees under Plan Pis 1%, cal- culated as follows: 4% (the ADPfor the NHCEs under Plan Pfor the prior year) 3 100/400 (the number of NHCEs in that prior year subgroup divided by the total number of NHCEs in all prior year sub- groups), which equals 1%. Thus, the prior year ADPfor NHCEs under Plan NP for the 1999 testing year is 5.5% (the sum of adjusted ADPs for the prior year sub- groups, 4.5% plus 1%). Example 2: (i) Employer C maintains a plan, Plan Q, which includes a section 401(k) plan and which uses the prior year testing method. Plan Q covers employees of Di- vision Aand Division B. In 1998, Plan Q had 500 eligible employees who were NHCEs, and the ADPfor those NHCEs for 1998 was 5%. Effective January 1, 1999, Employer C spins off a portion of Plan Q under §414(l), creating a new Plan R which includes a section 401(k) plan in which the 100 employees of Divi- sion B are eligible employees. (ii) The spin-off of Plan R is a plan coverage change that affects Plan Q. Ac- cordingly, for purposes of the 1999 test- ing year under Plan Q, the prior year ADP for NHCEs under Plan Q is the weighted average of the ADPs for the prior year subgroups. Plan Q has only one prior year subgroup (because the only NHCEs who would have been eligible employees under Plan Q for the 1998 plan year if the spin-off had occurred as of the first day of that plan year were eligible employees under Plan Q). Therefore, for purposes of the 1999 testing year under Plan Q, the ADPfor NHCEs for the prior year is the weighted average of the ADPs for the prior year subgroups, or 5%, the same as if the plan spin-off had not occurred. Example 3: (i) The facts are the same as in Exam- ple 2, except that instead of spinning off Plan R from Plan Q, Employer C amends the eligibility provisions under Plan Q to exclude employees of Division B effec- tive January 1, 1999. In addition, effec- tive on that same date, Employer C estab- lishes a new plan, Plan R, which includes a section 401(k) plan that uses the prior year testing method. The only eligible employees under Plan R are the 100 em- ployees of Division B who were eligible employees under Plan Q. (ii) Plan R is a successor plan, within the meaning of section Vof this notice (because all of the employees were eligi- ble employees under Plan Q in the prior year), and, therefore, the first plan year rule of that section does not apply. (iii) The amendment to the eligibility provisions of Plan Q and the establish- ment of Plan R are plan coverage changes that affect Plan Q and result in Plan R. Accordingly, the prior year ADPfor NHCEs under Plan Q is the weighted av- erage of the ADPs for the prior year sub- groups. Plan Q has only one prior year subgroup (because the only NHCEs who would have been eligible employees under Plan Q for the 1998 plan year if the amendment to the Plan Q eligibility pro- visions had occurred as of the first day of that plan year were eligible employees under Plan Q). Therefore, for purposes of the 1999 testing year under Plan Q, the ADPfor NHCEs for the prior year is the weighted average of the ADPs for the prior year subgroups, or 5%, the same as if the plan amendment had not occurred. (iv) Similarly, Plan R has only one prior year subgroup (because the only NHCEs who would have been eligible employees under Plan R for the 1998 plan year if the plan were established as of the first day of that plan year were eligible employees under Plan Q). Therefore, for purposes of the 1999 testing year under Plan R, the ADPfor NHCEs for the prior year is the weighted average of the ADPs for the prior year subgroups, or 5%, the same as that of Plan Q. Example 4: (i) The facts are the same as in Exam- ple 3, except that the provisions of Plan R extend eligibility to 50 hourly employees who previously were not eligible employ- ees under any section 401(k) plan main- tained by Employer C. (ii) Plan R is a successor plan, within the meaning of section Vof this notice (because 100 of Plan R’s 150 eligible em- ployees were eligible employees under another section 401(k) plan maintained by Employer C in the prior year), and, there- fore, the first plan year rule of that section does not apply. (iii) The establishment of Plan R is a plan coverage change that affects Plan R. Because the 50 hourly employees were not eligible employees under any section 401(k) plan of Employer C for the prior year, they do not comprise a prior year subgroup. Accordingly, Plan R still has only one prior year subgroup. Therefore, for purposes of the 1999 testing year under Plan R, the ADPfor NHCEs for the prior year is the weighted average of the ADPs for the prior year subgroups, or 5%, the same as that of Plan Q. VII. CHANGE FROM CURRENT YEAR TO PRIOR YEAR TESTING METHOD A. General Rule Section 401(k)(3)(A) provides that if an employer elects to use the current year test- ing method for purposes of the ADPtest, that method may not be changed except as provided by the Secretary. Asimilar rule applies under §401(m)(2)(A) in the case of the ACPtest. Thus, the statute indicates that once an employer elects to use the cur- rent year testing method, the ability to change that election will be limited. In general, it is expected that plans will select a testing method and retain it. January 20, 1998461998–3 I.R.B. Treasury and the Service recognize, how- ever, that there may be legitimate reasons for occasionally reevaluating and chang- ing the testing method under a plan. In addition, certain business transactions may result in a diversity of testing meth- ods among plans of an employer, and the employer may wish to use consistent test- ing methods. Finally, Treasury and the Service believe that employers with exist- ing plans should be given a period of time to decide whether to change from the cur- rent year testing method (which was the required testing method prior to the SBJPAchanges) to the prior year testing method. Accordingly, a plan is permitted to change from the current year testing method to the prior year testing method in any of the following situations: 1.The plan is not the result of the ag- gregation of two or more plans, and the current year testing method was used under the plan for each of the 5 plan years preceding the plan year of the change (or if lesser, the number of plan years the plan has been in existence, including years in which the plan was a portion of another plan). 2.The plan is the result of the aggrega- tion of two or more plans, and for each of the plans that are being aggregated (the aggregating plans), the current year test- ing method was used for each of the 5 plan years preceding the plan year of the change (or if lesser, the number of plan years since that aggregating plan has been in existence, including years in which the aggregating plan was a portion of another plan). 3.Atransaction occurs that is described in §410(b)(6)(C)(i) and §1.410(b)–2(f); as a result of the transaction, the employer maintains both a plan using the prior year testing method and a plan using the cur- rent year testing method; and the change from the current year testing method to the prior year testing year method occurs within the transition period described in §410(b)(6)(C)(ii). 4.The change occurs during the plan’s remedial amendment period for the SBJPAchanges (see Rev. Proc. 97–41). Notification to or filing with the Service of a change from the current year to the prior year testing method is not required in order for the change to be valid. How- ever, as provided in section IX of this no- tice, the plan document governing the plan must reflect such a change. B.Limitations on Double Counting of Certain Contributions If a plan changes from the current year testing method to the prior year testing method, then, for purposes of the first testing year for which the change is effec- tive, the ADPand ACPfor NHCEs for the prior year is determined in the following manner: 1.The ADPfor NHCEs for the prior year is determined taking into account only (a) elective contributions for those NHCEs that were taken into account for purposes of the ADPtest (and not the ACPtest) under the current year testing method for the prior year and (b) QNCs that were allocated to the accounts of those NHCEs for the prior year but that were not used to satisfy the ADPtest or the ACPtest under the current year testing method for the prior year. 2.The ACPfor NHCEs for the prior year is determined taking into account only (a) employee contributions for those NHCEs for the prior year, (b) matching contributions for those NHCEs that were taken into account for purposes of the ACPtest (and not the ADPtest) under the current year testing method for the prior year, and (c) QNCs that were allocated to the accounts of those NHCEs for the prior year but that were not used to satisfy the ACPtest or the ADPtest under the current year testing method for the prior year. Thus, in determining the ADPfor NHCEs for the prior year, the following contribu- tions made for the prior testing year are disregarded: QNCs used to satisfy either the ADPor ACPtest under the current year testing method for the prior testing year, elective contributions taken into ac- count for purposes of the ACPtest, and all QMACs. Similarly, in determining the ACPfor NHCEs for the prior year, the following contributions made for the prior testing year are disregarded: QNCs used to satisfy either the ADPor ACPtest under the current year testing method for the prior testing year, QMACs taken into account for purposes of the ADPtest, and all elective contributions. The limitations on double counting under this section VII.B. do not apply for testing years beginning before January 1, 1999. Accordingly, in the case of a plan that changes from the current year to the prior year testing method for the first time for either the 1997 or 1998 testing year, the ADPand ACPfor NHCEs used for that testing year are the same as the ADP and ACP, respectively, for NHCEs used for the prior testing year. 3.Examples The limitations on double counting are illustrated by the following examples: Example 1: (i) Employer Aestablished Plan M, a calendar year section 401(k) plan, in 1993 and, through the 2000 testing year, has al- ways used the current year testing method under Plan M. The ADPfor the HCEs under Plan M is 7% for the 2000 testing year. Based solely on elective contribu- tions by NHCEs under Plan M for the 2000 testing year, the ADPfor NHCEs for the 2000 testing year is 4%. In order to satisfy the ADPtest, Employer Aprovides a QNC to each NHCE for the 2000 testing year equal to 1% of compensation. No other contributions under Plan M are taken into account in determining the ADPfor NHCEs. Thus, the ADPfor NHCEs for the 2000 testing year is 5%. Plan M is amended to use the prior year testing method instead of the current year testing method for purposes of the ADP test for the 2001 testing year. (ii) In determining the ADPfor NHCEs under Plan M for the 2001 testing year in accordance with the prior year testing method, the elective contributions made by NHCEs under Plan M for the 2000 plan year are taken into account. However, the QNCs equal to 1% of com- pensation made under Plan M on behalf of NHCEs for the 2000 plan year are dis- regarded because they were used to sat- isfy the ADPtest for the 2000 testing year. Thus, for purposes of the 2001 testing year, the ADPfor NHCEs for the prior year is 4% (unless additional QNCs for NHCEs are timely contributed and allo- cated for the 2000 plan year). Example 2: (i) The facts are the same as in Exam- ple 1, except that the testing years are 1997 and 1998, instead of 2000 and 2001. (ii) For purposes of the 1998 testing year, the ADPfor NHCEs for the prior 1998–3 I.R.B47January 20, 1998 year is 5%. The QNCs equal to 1% of compensation made under Plan M on be- half of NHCEs that were used to satisfy the ADPtest for the 1997 testing year are not disregarded because the limitation on double counting applies only for testing years beginning on or after January 1, 1999. VIII. ANTI-ABUSE PROVISION This guidance is designed to provide simple, practical rules that accommodate legitimate plan changes. At the same time, the rules are intended to be applied by employers in a manner that does not make use of changes in plan testing pro- cedures or other plan provisions to inflate inappropriately the prior year ADPand ACPfor NHCEs (which are used as benchmarks for testing the ADPand ACP for HCEs). Further, the ADPand ACP tests are part of the overall requirement that benefits or contributions not discrimi- nate in favor of HCEs. Therefore, a plan will not be treated as satisfying the ADP or ACPtest if there are repeated changes in plan testing procedures or plan provi- sions that have the effect of distorting the ADPor ACPtest so as to increase signifi- cantly the permitted ADPor ACPfor HCEs and if a principal purpose of the changes was to achieve such a result. IX. PLAN PROVISIONS REGARDING TESTING METHOD Sections 1.401(k)–1(b)(2)(iii) and 1.401(m)–1(b)(2) require that a plan to which §401(k) or §401(m) applies must provide that the ADPor ACPtest will be met. Because a plan may now use either the current year testing method or the prior year testing method, a plan must specify which of these two testing meth- ods it is using. If the employer changes the testing method under a plan, the plan must be amended to reflect the change. Further, if the first plan year rule de- scribed in §401(k)(3)(E) and §401(m)(3) and section Vof this notice applies, a plan that incorporates these provisions by ref- erence must specify whether the ADPand ACPfor NHCEs for the prior plan year is 3% or the current year’s ADPand ACP for the NHCEs. The regulations under §401(k) and §401(m) permit a plan to incorporate by reference §401(k)(3) and §401(m)(2) (and, if applicable, §401(m)(9)) and the specific underlying regulations. Aplan that incorporates these provisions by ref- erence must continue to refer to the ap- plicable Code sections and the specific underlying regulations, must specify which of the two testing methods (prior year or current year) it is using, and must now provide that it is incorporating by reference subsequent Internal Revenue Service guidance issued under the applic- able Code provisions. Further, for pur- poses of the first plan year rule described in §401(k)(3)(E) and §401(m)(3) and section Vof this notice, a plan that incor- porates these provisions by reference must specify whether the ADPand ACP for NHCEs for the prior plan year is 3% or the current year’s ADPand ACPfor the NHCEs. Rev. Proc. 97–41 provides that quali- fied retirement plans have a remedial amendment period under §401(b) so that certain plan amendments for SBJPAgen- erally are not required to be adopted be- fore the last day of the first plan year be- ginning on or after January 1, 1999. Pursuant to Rev. Proc. 97–41, a plan pro- vision reflecting the ADPor ACPtesting method is a disqualifying provision, and thus any plan amendments to reflect a choice in testing method are not required to be adopted until the end of this reme- dial amendment period. However, plans must be operated in accordance with the SBJPAchanges to §401(k)(3)(A) and §401(m)(2)(A) as of the statutory effec- tive date. In addition, under Rev. Proc. 97–41, any retroactive amendments must reflect the choices made in the operation of the plan for each testing year, including the choice of testing method (and any changes to that election), and must reflect the date on which the plan began to oper- ate in accordance with those choices (and any such changes). X. PAPERWORK REDUCTION ACT The collection of information con- tained in this notice has been reviewed and approved by the Office of Manage- ment and Budget (OMB) in accordance with the Paperwork Reduction Act (44 U.S.C. 3507) under control number 1545–1579. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the col- lection of information displays a valid OMB control number. The collection of information in this notice is in section IX. This requirement to amend plan documents is necessary to reflect the new nondiscrimination test under §401(k)(3) and §401(m)(2) as amended by SBJPA. The pre-SBJPA method of nondiscrimination testing is still available under these Code sections and a plan amendment may not be re- quired to reflect the choice of the pre- SBJPAtesting method. The information will be used to determine whether the ADPand ACPof HCEs exceeds the ADP and ACPof NHCEs by more than the statutory limits. The collection of infor- mation is required to obtain a benefit. The likely respondents are businesses or other for-profit institutions, and nonprofit institutions. The estimated total annual recordkeep- ing burden is 49,000 hours. The esti- mated annual burden per recordkeeper is 20 minutes. The estimate number of recordkeepers is 147,000. Books or records relating to a collec- tion of information must be retained as long as their contents may become mater- ial in the administration of any Internal Revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103. XI. COMMENTS Treasury and the Service invite com- ments regarding the matters discussed in this notice. Comments may be submitted to the Service at CC:DOM:CORP:R (No- tice 98–1), Room 5226, Internal Revenue Service, P.O. Box 7604, Ben Franklin Sta- tion, Washington, DC 20044. Alterna- tively, taxpayers may hand-deliver com- ments between the hours of 8 a.m. and 5 p.m. to CC:DOM:CORP:R (Notice 97– XX), Courier’s Desk, Internal Revenue Service, 1111 Constitution Avenue, NW, Washington, DC, or may submit com- ments electronically via the Service’s In- ternet site at http://www.irs.ustreas. gov/prod/tax_regs/comments.html. Drafting Information The principal authors of this notice are Susan Lennon of the Office of the Associ- ate Chief Counsel (Employee Benefits and Exempt Organizations) and Roger Kuehnle of the Employee Plans Division. January 20, 1998481998–3 I.R.B. For further information regarding this no- tice, contact the Employee Plans Divi- sion’s telephone assistance service be- tween 1:30 and 4:00 p.m., Eastern Time, Monday through Thursday at (202) 622- 6074/75. (These telephone numbers are not toll-free.) Publicly Traded Partnerships Notice 98–3 This notice provides the method for grandfathered publicly traded partner- ships to elect to remain exempt from § 7704 of the Internal Revenue Code pur- suant to § 7704(g). This notice also pro- vides the procedures for revoking the election. In addition, this notice informs grandfathered publicly traded partner- ships that do not elect the application of § 7704(g) that the rules contained in pro- posed regulation § 1.743–2 regarding spe- cial § 743(b) basis accounts may be fol- lowed for purposes of a conversion from a partnership to a corporation. The refer- ences in this notice to § 7704(g) reflect the amendments made by the Taxpayer Relief Act of 1997 (1997 TRA), Pub. L. No. 105–34, 111 Stat. 788 (1997). BACKGROUND Section 7704(a) provides that a pub- licly traded partnership is treated as a cor- poration. Section 7704(b) defines a partnership as a “publicly traded partnership” if inter- ests in the partnership are traded on an es- tablished securities market or are readily tradable on a secondary market (or the substantial equivalent thereof). Section 7704(c) provides that a pub- licly traded partnership will not be treated as a corporation if, for the current taxable year and each preceding taxable year be- ginning after December 31, 1987 during which the partnership (or any predeces- sor) was in existence, (1) at least 90 per- cent of the gross income of the partner- ship consisted of certain “qualifying income” (as defined in § 7704(d)), and (2) the partnership would not be described in § 851(a) if the partnership were a domes- tic corporation. Section 7704 applies to taxable years beginning after December 31, 1987. However, for any existing partnership (as defined in § 10211(c)(2) of the Revenue Reconciliation Act of 1987 (1987 Act), 1987-3 C.B. 125), § 7704 applies to tax- able years beginning after December 31, 1997. The term “existing partnership” means any partnership that was a publicly traded partnership on December 17, 1987. If a substantial new line of business is added with respect to an existing partner- ship anytime after December 17, 1987, the grandfather status of the partnership terminates. Section 7704(g) was enacted as part of the 1997 TRA. Under § 7704(g), an ex- isting 1987 partnership may elect to re- main exempt from § 7704(a) by agreeing to pay each taxable year a 3.5 percent tax on gross income from the active conduct of all trades and businesses of the partner- ship. Apublicly traded partnership may make the election under § 7704(g) if: (1) the partnership is an existing partnership (as defined in § 10211(c)(2) of the 1987 Act), (2) § 7704(a) has not applied (and without regard to § 7704(c)(1) would not have applied) to the partnership for all taxable years beginning after December 31, 1987, and before January 1, 1998, and (3) the partnership elects the application of § 7704(g) for its first taxable year be- ginning after December 31, 1997, and consents to the application of the 3.5 per- cent tax imposed for each taxable year on gross income from the active conduct of all trades or businesses of the partnership. PROCEDURALREQUIREMENTS To make an election under § 7704(g), a partnership must file with the Memphis Service Center a statement that provides the following: (1) a notification at the top of the statement that an election is being made (that is, “ELECTION UNDER SECTION 7704(g) FILED PURSUANT TO NOTICE 98-3”); (2) the name of the partnership; (3) the federal tax identifica- tion number of the partnership; (4) the mailing address of the partnership; (5) the taxable year of the partnership; and (6) a declaration that, pursuant to § 7704(g), the partnership consents to the imposition of a 3.5 percent tax on gross income from the active conduct of all trades and busi- nesses by the partnership. The statement must be signed by the tax matters partner of the partnership (as defined under § 6231(a)(7)) and must be filed at any time on or before the 75th day of the first taxable year of the partnership beginning after December 31, 1997. The mailing address for the Memphis Service Center is Internal Revenue Service, Stop 1, 5333 Getwell Road, Memphis, TN 38118. TAX ON GROSS INCOME An electing partnership must pay each taxable year a tax of 3.5 percent of the gross income from all active trades and businesses conducted by the partnership. The tax is not deductible by the partner- ship. Pursuant to § 705(a)(2)(B), a part- ner of an electing partnership must reduce the adjusted basis of the partner’s partner- ship interest by a proportionate share of the 3.5 percent tax paid by the partner- ship. TERMINATION OF ELECTION If a partnership that elects special treat- ment under § 7704(g) adds a substantial new line of business after December 31, 1997, the election under § 7704(g) will terminate. The rules concerning a new line of business and the timing of a result- ing termination that are set forth in § 1.7704–2 of the regulations will be ap- plied to electing partnerships. In addition, a partnership may volun- tarily terminate its election at any time by filing a notice of revocation. The revoca- tion will be effective as of the date desig- nated in the notice, but not earlier than the date that the notice is filed with the Inter- nal Revenue Service. Once a partnership revokes or otherwise terminates its elec- tion under § 7704(g), the election may not be reinstated. If the partnership remains a publicly traded partnership on the date of the termination and does not meet the ex- ception for partnerships with passive-type income contained in § 7704(c), then ab- sent an actual transaction that eliminates the partnership, the conversion from a partnership to a corporation will be deter- mined under § 7704(f). PROCEDURALREQUIREMENTS FOR REVOCATION To make a revocation under § 7704(g), a partnership must file with the Memphis Service Center a statement that provides the following: (1) a notification at the top of the statement that a revocation is being made (that is, “REVOCATION UNDER 1998–3 I.R.B49January 20, 1998 SECTION 7704(g) FILED PURSUANT TO NOTICE 98–3”; (2) the name of the partnership; (3) the federal tax identifica- tion number of the partnership; (4) the mailing address of the partnership; (5) the taxable year of the partnership; (6) a dec- laration that, pursuant to § 7704(g), the partnership revokes its election to pay a 3.5 percent tax on gross income from the active conduct of all trades and businesses by the partnership; and (7) the effective date of the revocation. The statement must be signed by the tax matters partner of the partnership (as defined under § 6231(a)(7)). PARTNERSHIPS THATDO NOT ELECT If an existing partnership does not elect the special treatment of § 7704(g), then the partnership will become taxable as a corporation if it (1) remains a publicly traded partnership on the first day of its first taxable year beginning after Decem- ber 31, 1997, and (2) does not meet the exception for partnerships with passive- type income contained in § 7704(c). Ab- sent an actual transaction that eliminates the partnership, the conversion from a partnership to a corporation will be treated under § 7704(f) as an asset trans- fer from the partnership to the corporation followed by a liquidation of the partner- ship. On October 28, 1997, proposed regula- tions under § 743 were issued that provide that upon the contribution of assets by a partnership to a corporation, the special § 743 basis accounts are reflected in the basis of the assets in the hands of the cor- poration. 62 Fed. Reg. 55768, 1997–48 I.R.B. 13. Although these rules are in proposed form, the Service will not chal- lenge a taxpayer’s § 7704(f) conversion, or any actual transaction applying the conversion method of § 7704(f) that fol- lows the rules in proposed regulation § 1.743–2, so long as the conversion or transaction occurs prior to the issuance of further guidance on this issue. DRAFTING INFORMATION The principal author of this notice is Christopher Kelley of the Office of the Assistant Chief Counsel (Passthroughs and Special Industries). For further infor- mation regarding this notice, contact Christopher Kelley at (202) 622-3080 (not a toll-free number). Foreign Tax Credit Abuse Notice 98–5 Treasury and the Internal Revenue Ser- vice understand that certain U.S. taxpay- ers (primarily multinational corporations) have entered into or may be considering a variety of abusive tax-motivated transac- tions with a purpose of acquiring or gen- erating foreign tax credits that can be used to shelter low-taxed foreign-source in- come from residual U.S. tax. These trans- actions generally are structured to yield little or no economic profit relative to the expected U.S. tax benefits, and typically involve either: (1) the acquisition of an asset that generates an income stream subject to foreign withholding tax, or (2) effective duplication of tax benefits through the use of certain structures de- signed to exploit inconsistencies between U.S. and foreign tax laws. This notice an- nounces that Treasury and the Service will address these transactions through the issuance of regulations as well as by application of other principles of existing law, and requests public comment with respect to these and related foreign tax credit issues. I. BACKGROUND United States persons are subject to U.S. income tax on foreign-source as well as U.S.-source income. Subject to applic- able limitations, U.S. persons with for- eign-source income may credit income taxes imposed by foreign jurisdictions against their U.S. income tax liability on foreign-source income. Worldwide taxation of U.S. persons coupled with the allowance of a foreign tax credit establishes general tax neutral- ity between foreign and domestic invest- ment by U.S. taxpayers. Atax system that simply exempts foreign-source income from taxation creates an incentive for citi- zens and residents to invest overseas in low-taxed jurisdictions. On the other hand, worldwide taxation without a for- eign tax credit creates double taxation that distorts investment decisions by inhibit- ing foreign investment or business activi- ties. The foreign tax credit provisions of the Code, principally sections 901 through 907 and 960, effectuate Con- gress’s intent to provide relief from dou- ble taxation and alleviate these distor- tions. American Chicle Co. v. United States, 316 U.S. 450 (1942); Burnet v. Chicago Portrait Co.,285 U.S. 1 (1932). In contrast to certain tax credits that are intended to create an incentive for taxpay- ers to invest in certain activities, such as the research credit under section 41 or the low-income housing credit under section 42, the foreign tax credit is designed to re- duce the disincentive for taxpayers to in- vest abroad that would be caused by dou- ble taxation. In other words, the foreign tax credit is intended to preserve neutral- ity between U.S. and foreign investment and to minimize the effect of tax conse- quences on taxpayers’decisions about where to invest and conduct business. Relief from double taxation generally is not calculated separately with respect to each dollar of foreign-source income and tax. The foreign tax credit limitation or “basket” regime of section 904(d) permits, to a limited extent, a credit for foreign tax imposed with respect to income taxed at a rate in excess of the applicable U.S. rate to shelter from U.S. tax income from other, similar investments and activities that are subject to a relatively low rate of tax (the “cross-crediting regime”). Accordingly, the foreign tax credit provisions do not limit credits on an item-by-item basis. Rather, subject to certain restrictions, the provisions permit cross-crediting of for- eign taxes imposed with respect to speci- fied groups or types of income as consis- tent with the interrelated quality of multinational operations of U.S. persons. Multinational corporations that are sub- ject to relatively low rates of tax on their foreign-source income may be in an ex- cess limitation position. Generally, such taxpayers may properly use credits for foreign taxes imposed on high-taxed for- eign income to offset residual U.S. tax on their low-taxed foreign income. Treasury and the Service are concerned, however, that such taxpayers may enter into foreign tax credit-generating schemes designed to abuse the cross-crediting regime and ef- fectively transform the U.S. worldwide system of taxation into a system exempt- ing foreign-source income from residual U.S. tax. January 20, 1998501998–3 I.R.B. This result is clearly incompatible with the existence of the detailed foreign tax credit provisions and cross-crediting limi- tations enacted by Congress. No statutory purpose is served by permitting credits for taxes generated in abusive transactions designed to reduce residual U.S. tax on low-taxed foreign-source income. The foreign tax credit benefits derived from such transactions represent subsidies from the U.S. Treasury to taxpayers that oper- ate and earn income in low-tax or zero-tax jurisdictions. The effect is economically equivalent to the tax sparing benefits for U.S. taxpayers that Congress and the Treasury have consistently opposed in the tax treaty context because such benefits are inconsistent with U.S. tax principles and sound tax policy. II. ABUSIVE ARRANGEMENTS Treasury and the Service have identi- fied two classes of transactions that create potential for foreign tax credit abuse. The first class consists of transactions involv- ing transfers of tax liability through the ac- quisition of an asset that generates an in- come stream subject to foreign gross basis taxes such as withholding taxes. Transac- tions described in this class may include acquisitions of income streams through securities loans and similar arrangements and acquisitions in combination with total return swaps. In abusive arrangements in- volving such transactions, foreign tax credits are effectively purchased by a U.S. taxpayer in an arrangement where the ex- pected economic profit from the arrange- ment is insubstantial compared to the for- eign tax credits generated. The second class of transactions con- sists of cross-border tax arbitrage transac- tions that permit effective duplication of tax benefits. Duplicate benefits result when the U.S. grants benefits and, in ad- dition, a foreign country grants benefits (including benefits from a full or partial imputation or exemption system, or a preferential rate for certain income) to separate persons with respect to the same taxes or income. These duplicate benefits generally can result where the U.S. and a foreign country treat all or part of a trans- action or amount differently under their respective tax systems. In abusive arrangements involving such transactions, the U.S. taxpayer exploits these inconsis- tencies where the expected economic profit is insubstantial compared to the for- eign tax credits generated. The following are examples of abusive arrangements within the scope of this no- tice. Example 1 On June 29, 1998, US, a domestic corporation, purchases all rights to a copyright for $75.00. The copyright will expire shortly and the only income expected to be received with respect to the copyright is a royalty payable June 30, 1998. The gross amount of the royalty is expected to be $100.00. The royalty payment is subject to a 30-percent Country X withholding tax. On June 30, 1998, US receives the $100.00 royalty payment, less the $30.00 withholding tax. USreasonably expects to incur a $5.00 economic loss (having paid $75.00 for the right to receive a $70.00 net royalty payment), but expects to acquire a $30.00 foreign tax liability. In this example, US has effectively purchased for- eign tax credits in a transaction that was reasonably expected to result in an economic loss. Example 2 On June 29, 1998, US, a domestic corporation, purchases a foreign bond for $1096.00 (including accrued interest). The foreign bond provides for an- nual interest payments of $100.00 payable June 30 of each year. The interest payments are subject to a 4.9-percent Country X withholding tax. On June 30, 1998, USreceives a $95.10 interest payment on the bond (net of a $4.90 Country X withholding tax). On July 4, 1998, USsells the bond for $1001.05. Because the value of the bond is not reasonably ex- pected to appreciate due to market factors, USrea- sonably can expect only a $0.15 economic profit (the $1001.05 sales price and the $95.10 net interest coupon, less the $1096.00 purchase price) and ex- pects to acquire a $4.90 foreign tax liability. In this example, UShas effectively purchased foreign tax credits in a transaction with respect to which the rea- sonably expected economic profit is insubstantial in relation to expected U.S. foreign tax credits. No im- plication is intended as to whether the interest de- scribed in this example will constitute high with- holding tax interest under section 904(d)(2)(B). Example 3 F, an entity that does not receive a tax benefit from foreign tax credits, wishes to acquire a foreign bond with a value of $1000.00 that provides for an- nual interest payments of $100.00. The interest pay- ments are subject to a 4.9-percent Country X with- holding tax. Instead of purchasing the bond, F invests its $1000.00 elsewhere and enters into a three-year notional principal contract (NPC) with US, an unrelated domestic corporation. Under the terms of the NPC, USagrees to make an annual pay- ment to Fequal to $96.00 and Fagrees to make an annual payment to USequal to the product of $1000.00 and a rate calculated based on LIBOR. In addition, the parties agree that, upon termination of the NPC, USwill make a payment to Fbased on the appreciation, if any, in the value of the foreign bond, and Fwill make a payment to USbased on the de- preciation, if any, in the value of the foreign bond. In order to hedge its obligations under the NPC, US purchases the bond for $1000.00. Assume that, in connection with the purchase of the foreign bond, USincurs or maintains an additional $1000.00 of borrowing at an interest rate equal to the LIBOR- based rate provided for in the NPC. At the time USenters into this arrangement, US reasonably expects to incur an annual $0.90 eco- nomic loss each year under the arrangement (the $95.10 net interest payment on the bond plus the LIBOR-based amount received from Funder the NPC, less the sum of the $96.00 payment to Funder the NPC and the LIBOR-based amount associated with the $1000.00 borrowing incurred or maintained in order to acquire the foreign bond). In this exam- ple, UShas effectively purchased foreign tax credits in a transaction that was reasonably expected to re- sult in an economic loss. Example 4 US, a domestic corporation, forms N, a Country X corporation, by contributing $10.00 to the capital of Nin exchange for the only share of Ncommon stock. Nborrows $90.00 from F, a Country X indi- vidual unrelated to US, at an annual interest rate of 7.5 percent, and Npurchases preferred stock of an unrelated party with a par value of $100.00 or a bond with a face amount of $100.00. USreasonably expects the preferred stock or bond to pay dividends or interest at an annual rate of 10 percent. Alterna- tively, rather than purchasing preferred stock or the bond, Nlends $100.00 to USat an annual interest rate of 10 percent. Country X treats the Floan as an equity invest- ment and does not allow a deduction for N’s interest expense. Country X imposes an individual income tax and a corporate income tax of 30 percent. Coun- try X thus is expected to impose a $3.00 corporate income tax each year on N. Country X has an impu- tation system, under which dividends from Country X corporations are excluded from the gross income of Country X individuals. (Asimilar result could be achieved if the dividends are wholly or partially ex- empt from Country X tax due to a consolidated re- turn or group relief regime, a dividend-received de- duction, or an imputation credit.) At the time USenters into this arrangement, US reasonably expects that Nwill have annual earnings and profits of $0.25 ($10.00 dividend or interest in- come from the preferred stock or bond (or $10.00 in- terest income from the loan to US), less $6.75 inter- est expense and $3.00 foreign tax liability). US expects that each year Nwill pay a $0.25 dividend to USand USwill claim a $3.00 foreign tax credit for taxes deemed paid under section 902. In this exam- ple, UShas entered into an arrangement to exploit the inconsistency between U.S. and Country X tax laws in order to generate foreign tax credits in a transaction with respect to which the reasonably ex- pected economic profit is insubstantial in relation to expected U.S. foreign tax credits. Example 5 US, a domestic corporation, forms N, a Country X entity. UScontributes $100.00 to the capital of N in exchange for a 100-percent ownership interest. N borrows $900.00 from F, an unrelated Country X corporation, at an annual interest rate of 8 percent, and Npurchases preferred stock of an unrelated 1998–3 I.R.B51January 20, 1998 party with a par value of $1000.00 that USreason- ably expects to pay dividends at an annual rate of 10 percent. The dividends are subject to a Country Y 25-percent withholding tax. Country X treats the Floan as an equity invest- ment in Nand treats Nas a partnership. Conse- quently, Fclaims a foreign tax credit in Country X for 90 percent of the withholding tax paid by N. Under U.S. law, the Floan is respected as debt, and Nis disregarded as a separate entity (a partnership with only one partner). SeeReg. § 301.7701-3(a) and § 301.7701-3(b)(2)(C). Thus, USclaims a U.S. foreign tax credit for the taxes paid by Nand the tax benefit of the foreign taxes paid by Nare effectively duplicated. At the time USenters into this arrangement, US reasonably expects an annual profit of $3.00 ($100.00 dividend income, less $72.00 interest ex- pense and $25.00 foreign tax liability) and an annual foreign tax credit of $25. In this example, UShas entered into an arrangement to exploit the inconsis- tency between U.S. and Country X tax laws in order to generate foreign tax credits in a transaction with respect to which the reasonably expected economic profit is insubstantial in relation to expected U.S. foreign tax credits. III. REGULATIONS TO BE ISSUED PURSUANTTO THIS NOTICE Regulations will be issued to disallow foreign tax credits for taxes generated in abusive arrangements such as those de- scribed in Part II above. These regula- tions will be issued under the authority of some or all of the following sections of the Internal Revenue Code of 1986: sec- tion 901, section 901(k)(4), section 904, section 864(e)(7), section 7701(l), and section 7805(a). In general, these regulations will disal- low foreign tax credits in an arrangement such as those described in Part II above from which the reasonably expected eco- nomic profit is insubstantial compared to the value of the foreign tax credits ex- pected to be obtained as a result of the arrangement. The regulations will em- phasize an objective approach to calculat- ing expected economic profit and credits, and will require that the determination of expected economic profit reflect the like- lihood of realizing both potential gain and potential loss (including loss in excess of the taxpayer’s investment). Thus, under the regulations, expected economic profit will be determined without regard to ex- ecutory financial contracts (e.g.,a no- tional principal contract, forward con- tract, or similar instrument) that do not represent a real economic investment or potential for profit or that are not properly treated as part of the arrangement. Fur- ther, the regulations will require that ex- pected economic profit be determined over the term of the arrangement, prop- erly discounted to present value. It is expected that the regulations in general and any test relying on a compari- son of economic profit and credits in par- ticular would be applied to discrete arrangements. The utility of a test com- paring profits and credits depends upon the proper delineation of the arrangement to be tested. If necessary to effectuate the purposes of the regulations, a series of re- lated transactions or investments may be treated as a single arrangement or por- tions of a single transaction or investment may be treated as separate arrangements. The proper grouping of transactions and investments into arrangements will de- pend on all relevant facts and circum- stances. For example, a series of transactions involving a purchase and resale might be treated as a single arrangement. Simi- larly, an investment together with related hedging and financing transactions,e.g.,a borrowing, an investment, and an asset swap designed to limit the taxpayer’s eco- nomic exposure with respect to the invest- ment, might be treated as a single arrangement. In addition, if a controlled foreign corporation, as part of its busi- ness, enters into a buy-sell transaction in- volving a debt instrument, that buy-sell transaction could be treated as a separate arrangement. In general, reasonably expected eco- nomic profit will be determined by taking into account foreign tax consequences (but not U.S. tax consequences). How- ever, it is inappropriate in the context of the U.S. foreign tax credit system to allow foreign tax credits with respect to abusive arrangements simply because the arrange- ments generate substantial foreign tax savings. Accordingly, the regulations will provide that the calculation of expected economic profit will not include expected foreign tax savings attributable to a tax credit or similar benefit allowed by a for- eign country with respect to a tax paid to another foreign country. In general, expected economic profit will be determined by taking into account expenses associated with an arrangement, without regard to whether such expenses are deductible in determining taxable in- come. For example, in determining eco- nomic profit, foreign taxes will be treated as an expense. In addition, interest ex- pense (and similar amounts, including borrowing fees, “in lieu of” payments, forward contract payments, and notional principal contract payments) generally will be taken into account in determining expected economic profit only to the ex- tent that the indebtedness or contract giv- ing rise to the expense is part of the arrangement. In addition, the regulations will provide special rules that will operate to deny credits for foreign taxes generated in abu- sive arrangements involving asset swaps or other hedging devices (including rules that allocate interest expense to an arrangement in certain cases other than pursuant to a tracing approach). For ex- ample, an arrangement involving a pur- chase of a foreign security coupled with an asset swap that is designed to hedge substantially all of the taxpayer’s risk of loss with respect to the security for the duration of the arrangement generally will constitute an abusive foreign tax credit arrangement even if the taxpayer has not incurred indebtedness for the specific pur- pose of acquiring the asset. However, the regulations will not treat arrangements in- volving debt instruments as abusive solely because the taxpayer diminishes its risk of interest rate or currency fluctua- tions, unless the taxpayer also diminishes its risk of loss with respect to other risks (e.g.,creditor risk) for a significant por- tion of the taxpayer’s holding period. See Part VI of this notice for additional rules for portfolio hedging strategies and partial hedges. Under the foregoing principles, the reg- ulations will not disallow foreign tax credits merely because income from the arrangement is subject to a high foreign tax rate. Treasury and the Service antici- pate that credits for taxes paid to a high- tax jurisdiction will not be subject to dis- allowance under the regulations absent other indicia of abuse. The regulations generally will not dis- allow a credit for withholding taxes on dividends if the holding period require- ment of section 901(k) is satisfied. How- ever, the regulations will operate to deter- mine whether foreign tax credits with respect to cross-border tax arbitrage arrangements (as described in Part II, above) will be disallowed, even if such January 20, 1998521998–3 I.R.B. credits arise with respect to withholding taxes on dividends and the section 901(k) holding period is satisfied. In addition, the regulations generally will apply to de- termine whether credits should be disal- lowed with respect to qualified taxes (as defined in section 901(k)(4)(B)) that are not subject to the general section 901(k) holding period rule. For example, the regulations may disallow credits with re- spect to gross basis taxes paid or accrued with respect to certain arrangements in- volving equity swaps and equity buy-sell transactions entered into by securities dealers even if such credits would not have been disallowed under section 901(k) pursuant to section 901(k)(4). See section 901(k)(4)(C). IV. EFFECTIVE DATE OF REGULATIONS ISSUED PURSUANTTO THIS NOTICE The regulations to be issued with re- spect to arrangements of the kind de- scribed in Part II above generally will be effective with respect to taxes paid or ac- crued on or after December 23, 1997, the date this notice was issued to the public. The effective date of the regulations is- sued pursuant to this notice, however, will not limit the application of other princi- ples of existing law to determine the proper tax consequences of the structures or transactions addressed in the regula- tions. V. IRS COORDINATION PROCEDURES The Service intends to carefully exam- ine foreign tax credits claimed in arrange- ments of the type described in Part II to determine whether such credits should be disallowed under existing law even with- out application of the regulations to be is- sued pursuant to this notice. The Service plans to establish early coordination pro- cedures utilizing foreign tax credit experts in the National Office and the Interna- tional Field Assistance Specialization Program to assist examining agents in an- alyzing these transactions. These coordi- nation procedures will continue in effect following issuance of the regulations to ensure uniform and appropriate applica- tion of the regulations by examining agents. VI. OTHER FOREIGN TAX CREDIT GUIDANCE Treasury and the Service are consider- ing issuing other guidance to ensure that foreign tax credits are allowed to U.S. taxpayers in a manner consistent with the overall structure of the Code and the in- tent of Congress in enacting the credit. For example, Treasury and the Service are considering issuing additional regulations under section 904(d)(2)(B)(iii) to address abusive transactions involving high with- holding taxes. Treasury and the Service are also considering whether additional approaches may be necessary to identify abuses in the case of foreign gross basis taxes generally. In addition, Treasury and the Service are considering various approaches to ad- dress structures (including hybrid entity structures) and transactions intended to create a significant mismatch between the time foreign taxes are paid or accrued and the time the foreign-source income giving rise to the relevant foreign tax liability is recognized for U.S. tax purposes. For such structures and transactions, Treasury and the Service are considering either de- ferring the tax credits until the taxpayer recognizes the income, or accelerating the income recognition to the time at which the credits are allowed (e.g.,by allocating the credits or the income under section 482). Finally, Treasury and the Service are concerned about credits claimed in trans- actions described in Part II above, with respect to assets or income streams that are hedged pursuant to portfolio hedging strategies and with respect to hedges en- tered into with respect to assets or income streams that the taxpayer holds without diminished risk of loss for a significant period of time. In general, regulations addressing these other foreign tax credit issues will be ef- fective no earlier than the date on which proposed regulations (or other guidance such as a notice) describing the tax conse- quences of the arrangements are issued to the public. The effective date of any such regulations will not, however, affect the application of other principles of existing law to determine the proper tax conse- quences of the structures or transactions addressed in the regulations. VII. COMMENTS Comments are requested on the matters discussed in this notice. Written comments may be submitted to the Internal Revenue Service, P.O. Box 7604, Ben Franklin Sta- tion, Attention: CC:DOM:CORP:R (No- tice 98–5), Room 5226, Washington DC 20044. Submissions may be hand deliv- ered between the hours of 8 a.m. and 5 p.m. to CC:DOM:CORP:R (Notice 98–5), Courier’s Desk, Internal Revenue Service, 1111 Constitution Avenue NW, Washing- ton DC. Alternatively, taxpayers may sub- mit comments directly to the IRS Internet site at http://www.irs.ustreas.gov/prod/tax_ regs/comments.html. Comments will be available for public inspection and copy- ing. For further information regarding this notice, contact Seth Goldstein or Rebecca Rosenberg of the Office of Associate Chief Counsel (International) at 202-622- 3850 (not a toll-free call). Qualified Funeral Trusts Notice 98–6 PURPOSE Section 1309 of the Taxpayer Relief Act of 1997, Pub. L. No. 105-34, 111 Stat. 788 (the Act) added § 685 of the Internal Revenue Code to permit certain trusts to elect Qualified Funeral Trust (QFT) sta- tus. This notice provides guidance on QFTeligibility requirements, election procedures, and simplified reporting re- quirements. BACKGROUND Apre-need funeral trust arises from an arrangement where funeral merchandise or services are purchased from a seller to benefit a specified beneficiary before the beneficiary’s death. Apre-need cemetery merchandise trust arises from an arrange- ment where cemetery merchandise or ser- vices are purchased from a seller to bene- fit a specified beneficiary before the beneficiary’s death. The purchaser enters into a contract with the seller of the fu- neral or cemetery merchandise or services whereby the purchaser selects the mer- chandise and services to be provided upon the death of the beneficiary, and agrees to 1998–3 I.R.B53January 20, 1998 pay for them before the beneficiary’s death. Under state law, such amounts (or a portion thereof) are required to be held in trust during the beneficiary’s lifetime and are paid to the seller upon the benefi- ciary’s death. Rev. Rul. 87–127, 1987–2 C.B. 156, addresses the taxation of pre-need funeral trusts. The ruling provides four situations under which funeral trusts are formed and concludes that in all four situations the trust is a grantor trust and the purchaser is treated for federal tax purposes as the owner of the trust. Any amount that a seller receives from the trust (as payment for services or merchandise) is includible in the gross income of the seller. Section 685 permits the trustees of cer- tain pre-need trusts to elect QFTstatus on behalf of the trusts. If the election is made, a trust is not treated as a grantor trust and the purchaser would not be sub- ject to tax on trust income. The trustee is liable for the tax on the taxable income of the trust as determined in accordance with the income tax rate schedule generally ap- plicable to estates and trusts. However, the personal exemption deduction under § 642(b) is unavailable. QFTELIGIBILITYREQUIREMENTS Section 685(b) defines a QFTas any trust (other than a foreign trust) if—(1) the trust arises as a result of a contract with a person engaged in the trade or business of providing funeral or burial services or property necessary to provide such services, (2) the sole purpose of the trust is to hold, invest and reinvest funds in the trust and to use the funds solely to make payments for those services or property for the benefit of the beneficia- ries of the trust, (3) the only beneficiaries of the trust are individuals with respect to whom those services or property are to be provided at their death under contracts de- scribed in item (1), (4) the only contribu- tions to the trust are contributions by or for the benefit of those beneficiaries, (5) the trustee elects the application of this subsection, and (6) the trust would, but for this election, be treated as owned under subpart E (the grantor trust provi- sions) by the purchasers of the contracts. Pre-need cemetery merchandise trusts are substantially similar to pre-need fu- neral trusts and therefore the analysis in Rev. Rul. 87–127 applies to them. Pre- need funeral trusts and pre-need cemetery merchandise trusts that meet one of the situations under Rev. Rul. 87–127 are grantor trusts and the purchasers of the contracts giving rise to the trusts are the owners of the trusts. Accordingly, these trusts may elect to be treated as QFTs if they meet the other QFTrequirements under § 685. AQFTcannot accept aggregate contri- butions by or for the benefit of an individ- ual in excess of $7,000 (contribution limit). Section 685(c)(1). Section 685(c)(2) pro- vides that for purposes of § 685(c)(1), all trusts having trustees that are related per- sons shall be treated as 1 trust. Persons are related if (A) the relationship between the persons is described in §§ 267 or 707(b), (B) the persons are treated as a single em- ployer under subsection (a) or (b) of § 52, or (C) the Secretary determines that treat- ing the persons as related is necessary to prevent avoidance of the purposes of this section. The $7,000 contribution limit is adjusted annually for inflation for any con- tracts entered into after calendar year 1998. Section 685(c)(3). Atrust is deemed to exceed the contri- bution limit under § 685(c) if the trust is determined, over the anticipated life of the trust, to receive projected contribu- tions (based upon existing contributions, the applicable state law trust contribution requirements, and any expected contribu- tions in excess of the state law require- ments) that exceed the contribution limit. The determination is made at the incep- tion of the trust and is made again when the amount of the projected contributions used in the previous determination changes. For example, a trust that is de- termined at its inception to exceed the contribution limit during the life of the trust will be deemed to exceed the contri- bution limit at inception. However, a trust that is determined at its inception not to exceed the contribution limit but ex- ceeds the contribution limit in a future year, due to a change in projected contri- butions, will be deemed to exceed the contribution limit at the time of the change in projected contributions. Atrust loses its QFTstatus at the time that it is deemed to exceed the contribution limit. If a QFThas multiple beneficiaries, the contribution limit will apply separately to each beneficiary. AQFTthat has multiple beneficiaries will be taxed as if each ben- eficiary’s interest in the QFTis a separate trust. Each beneficiary’s share of the total contributions to a trust and share of the trust’s income is determined in accor- dance with the beneficiary’s interest in the trust; a beneficiary’s interest in a trust may be determined under any reasonable method. QFTELECTION PROCEDURES Atrustee may elect QFTstatus for trusts that meet the requirements of QFTs under § 685 for taxable years ending after August 5, 1997. Therefore, trusts existing prior to August 5, 1997, and trusts created after August 4, 1997, may elect QFTsta- tus. The filing of Form 1041–QFTis treated as the election. The election must be filed no later than the due date, with extensions, for filing the trust income tax return for the year of election. The elec- tion applies to each trust reported in the QFTreturn. Atrustee need not elect QFTstatus for the trust’s first eligible year; even if no election is made for the first eligible year, a QFTelection may be made for subse- quent tax years. AQFTelection, once made, cannot be revoked without the con- sent of the Commissioner. Under both § 685 and Rev. Rul. 87– 127, amounts received by the seller from a trust are treated as payments for services and merchandise and are includible in the gross income of the seller in the taxable year received or properly accrued under the seller’s method of accounting. In the case where a seller was not reporting in- come in accordance with Rev. Rul. 87– 127, for example, where a seller improp- erly reported investment income in the taxable year it was earned by the trust rather than the purchaser reporting such income, a duplication of income may re- sult from an election under § 685. The Service is continuing to study this issue. SIMPLIFIED QFTREPORTING REQUIREMENTS Atrustee of a QFTis required to file a trust return on behalf of the QFT. The proper form to file is Form 1041–QFT. A trustee may file one aggregate Form 1041–QFTfor all of its QFTs and should follow the instructions associated with that form. January 20, 1998541998–3 I.R.B. REQUESTS FOR COMMENTS The Treasury and the Service invite comments from the public on issues that may arise in implementing § 685. Send written comments to the following address: Internal Revenue Service CC:DOM:CORP(NT98-6; CC:DOM:P&SI:1) P.O. Box 7604, Ben Franklin Station Washington, DC 20044 Alternatively, send written comments electronically via the Internet to the IRS Internet site at http://www.irs.ustreas.gov/ prod/tax_regs/comments.htm1. Please identify the comments as relating to this Notice. DRAFTING INFORMATION The principal author of this notice is Daniel J. Coburn of the Office of Assis- tant Chief Counsel (Passthroughs and Special Industries). For further informa- tion regarding this notice contact Mr. Coburn at (202) 622-3050 (not a toll-free call). Returns Relating to Interest on Education Loans Notice 98–7 PURPOSE This notice describes the information reporting requirements for 1998 under § 6050S of the Internal Revenue Code (as enacted by the Taxpayer Relief Act of 1997, Pub. L. No. 105–34, § 202(c), 111 Stat. 804 (the Act)) that apply to certain persons who receive payments of interest that may be deductible as qualified educa- tion loan (“student loan”) interest. The Treasury Department intends to issue reg- ulations on the information reporting re- quired under § 6050S. Pending the is- suance of those regulations, this notice describes who must report information with respect to payments of student loan interest, and the nature of the information that will be required under § 6050S for 1998. For 1998, payees are required to report interest received only with respect to stu- dent loans that have a “covered period” (described below) ending during or after 1998. Comments are requested regarding the student loan interest reporting require- ments that should apply for future years. The Internal Revenue Service will issue additional guidance on the student loan interest that a taxpayer may deduct, in- cluding further guidance for determining whether a taxpayer has made a payment of interest on a student loan during the first 60 months in which interest pay- ments are required. BACKGROUND A. The Student Loan Interest Deduction. Section 202(a) of the Act added § 221 to the Code. Section 221 allows certain taxpayers who pay interest on qualified education loans to claim a federal income tax deduction for their interest payments, regardless of whether they itemize other deductions. Aqualified education loan is a loan used to pay the costs of attendance at an eligible educational institution for a stu- dent enrolled at least half-time in a pro- gram leading to a degree, certificate, or other recognized educational credential. The student must be the taxpayer, the tax- payer’s spouse, or the taxpayer’s depen- dent at the time the loan was taken. A loan made by an individual who is related to the borrower, within the meaning of § 267(b) or § 707(b)(1), is not a qualified education loan. An eligible educational institution is any college, university, vocational school, or other postsecondary educational insti- tution that is described in § 481 of the Higher Education Act of 1965 (20 U.S.C. 1088) and, therefore, is eligible to partici- pate in the student aid programs adminis- tered by the Department of Education. This category includes virtually all ac- credited public, nonprofit, and proprietary postsecondary institutions. For purposes of the student loan interest deduction, eli- gible educational institutions also include institutions that conduct an internship or residency program leading to a degree or certificate awarded by an institution of higher education, a hospital, or a health care facility that offers postgraduate train- ing. Costs of attendance are generally the same as those described in § 472 of the Higher Education Act for purposes of cal- culating a student’s financial need (e.g., tuition, fees, room, board, books, equip- ment, and other necessary expenses, such as transportation). However, for purposes of the student loan interest deduction, costs of attendance are reduced by educa- tional assistance that the student receives and excludes from gross income under § 127, 135, 530, or as a scholarship. The student loan interest deduction is available only for interest payments made during the first 60 months, whether or not consecutive, in which interest payments are required on the loan. Notice 97-60, 1997-46 I.R.B. 8, provides additional in- formation about the student loan interest deduction. B. Information Reporting Relating to Student Loan Interest. Section 6050S(a) requires information reporting by any person engaged in a trade or business who, in the course of that trade or business, receives from any individual interest aggregating $600 or more for any calendar year on 1 or more qualified education loans. Section 6050S(b) provides that the re- turn of information must be in the form prescribed by the Secretary and contain: (1) the name, address, and taxpayer identification number (TIN) of the indi- vidual with respect to whom interest was received, (2) the name, address, and TIN of any individual certified by the individual named in the first item as the taxpayer who will claim that individual as a depen- dent for purposes of the deduction under § 151 for any taxable year ending with or within the year for which the information return is filed, (3) the aggregate amount of interest re- ceived for the calendar year with respect to the individual named in the first item, and (4) such other information as the Secre- tary may prescribe. Section 6050S(c) states that informa- tion reporting is required by governmental units or any agency or instrumentality thereof. The return required by the gov- ernmental entity must be made by the offi- cer or employee appropriately designated for the purpose of making the return. Section 6050S(d) provides that every person required to make an information return under § 6050S(a) must also furnish to each individual whose name is required to be included in the return a written state- ment showing the name, address, and phone number of the reporting person’s information contact, and the aggregate amounts required to be included in the re- turn. Section 6050S(f) provides that, in the case of any amount received on behalf of another person, only the person first re- ceiving the amount is required to make the return under § 6050S. Thus, where more than one person has a connection with a qualified education loan, the per- son first receiving the payment of interest, such as a loan servicer or collection agent receiving payments on behalf of the lender, is required to file an information return regarding the interest received on the loan. DISCUSSION A. Definitions. The following definitions apply to these terms for purposes of this notice: (1) Payee. Apayee is the person first receiving one or more interest payments on a student loan. (2)Payor.Apayor is the individual with respect to whom interest payments are received on a particular student loan. (3) Consolidated Loan.Aconsolidated loan is a single loan refinancing more than one student loan. (4) Collapsed Loan.Acollapsed loan is a set of loans of a single payor treated as a single loan for loan servicing pur- poses. (5) Defaulted Loan.Adefaulted loan is a loan with respect to which required pay- ments of interest and principal have not been made when due over a period of time such that the holder has declared the loan in default based on its terms and con- ditions, and, if applicable, sought re- course against the ultimate guarantor of the loan. (6) Covered Period.For loans other than consolidated loans, collapsed loans, and defaulted loans, the covered period begins on: (a) the date on which the loan went into repayment status if the payee knows or has reason to know that date; or (b) January 1, 1998, if the payee does not know and does not have reason to know that date. For consolidated loans and collapsed loans, the covered period begins on: (a) the most recent date on which any of the loans subject to consolidation or collapse went into repayment status, if the payee knows or has reason to know that date; or (b) January 1, 1998, if the payee does not know and does not have reason to know that date. For defaulted loans, the covered period begins on: (a) the date the loan went into repay- ment status if the payee knows or has rea- son to know that date; (b) the date the loan went into default, if the payee knows or has reason to know that date and does not know or have rea- son to know the date the loan went into repayment status; or (c) January 1, 1998, if the payee does not know and does not have reason to know the dates the loan went into repay- ment status or default. The covered period ends on the date that is 60 months after the date on which the period starts or, if later, the last day of the month in which that 60-month date oc- curs. However, if the payee knows or has reason to know of any periods of grace, deferment, or forbearance during the cov- ered period, the covered period is ex- tended by the number of months the loan was subject to grace, deferment, or for- bearance. (7) Covered Student Loan.Acovered student loan is a loan with a covered pe- riod ending during or after 1998 that is ei- ther: (a) subsidized, guaranteed, financed, or otherwise treated as a student loan under a program of the federal, state, or local gov- ernment or an institution of postsecondary education, or (b) certified by the payor as a student loan. B. Who Must File for 1998. Payees who receive interest aggregat- ing $600 or more during 1998 with re- spect to a single payor on one or more covered student loans must file an infor- mation return with respect to that interest. C. Information Required for 1998. Payees required under this notice to file information returns for 1998 must prop- erly complete Form 1098–E, Student Loan Interest Statement, for all student loan accounts that contain one or more covered student loans (“student loan ac- count”). Apayee may file a separate Form 1098-E for each student loan ac- count of the payor, or a single Form 1098- E for all student loan accounts of the payor. For 1998, a properly completed Form 1098-E filed with the Service must in- clude: (1) the name, address, and TIN of the payee; (2) the name, address, and TIN of the payor; and (3) the aggregate amount of interest re- ceived during 1998 with respect to the student loans in the account or accounts included on the return. D. Mixed Use Loans and Revolving Accounts. Payments of interest made on or after January 1, 1998, on mixed use loans or re- volving accounts, such as credit card ac- counts, are treated as interest paid with re- spect to a student loan (and must be reported as such) only if the mixed use loan or revolving account is certified to be, in part, a student loan, and the payee has a reasonable method for allocating the interest payments to the part of loan that is certified to be a student loan. E. Coordination with Reporting on Payments of Mortgage Interest. If, for a year before 1998, a payee treated a loan as a mortgage within the de- finition of § 6050H(e) for purposes of the information reporting required under § 6050H, the payee must continue to treat the loan as a mortgage for information re- porting purposes, even if all or part of the loan is used to pay costs of attendance. For loans made on or after January 1, 1998, the payee must treat loans secured by real property and not made exclusively to acquire or improve real property as ei- ther mortgages or student loans in accor- dance with the certification provided by the payor. Thus, if a payor certifies all of a loan secured by real property and made on or after January 1, 1998, as a student loan, the payee must treat the entire loan as a student loan and not as a mortgage for purposes of information reporting. If the payor certifies part of a loan as a stu- dent loan, only the certified portion of the loan may be treated as a student loan for purposes of information reporting. For 1998–3 I.R.B55January 20, 1998 loans made on or after January 1, 1998, the payee must treat a loan secured by real property and made exclusively to acquire or improve real property as a mortgage and provide information returns as re- quired by § 6050H. The regulations under § 6050H will be amended to be consistent with this rule. F. When To File. The information returns required under § 6050S for 1998 must be sent to the Ser- vice by March 1, 1999. G. Manner of Filing. The regulations under § 6011 will be amended to require any person required to file 250 or more Forms 1098–E for 1998 to file those returns by magnetic media or electronically. Additional guidance will be provided on how to file by magnetic media or electronically. H. Statements To Be Provided to Payors. The payee must provide each payor a statement containing the same informa- tion that is provided to the Service on the information return required by § 6050S. In addition, the statement provided to the payor must contain a phone number for the individual serving as information con- tact of the payee. The statement must also notify the payor that the amount of interest reported as paid may differ from the amount of interest that the payor may be able to claim as a deduction. The statement must be provided to the payor by February 1, 1999. The statement may be a copy of Form 1098–E (or an accept- able substitute statement). I. Collecting Information. The Service is developing an optional Form W-9S for use in collecting informa- tion for the purpose of complying with § 6050S. The payee will be able to use the form to collect the information necessary to meet the information reporting require- ments of § 6050S. The information can be collected on paper or on an electronic version of Form W–9S (or an acceptable substitute). The payee also may collect the necessary information by using its own forms and procedures. J. Waiver of Penalties. The Treasury Department intends to issue regulations under § 6050S, and modify the regulations under § 6050H, to provide guidance on how payees are to comply with the requirements of the statute. Until the regulations are adopted, no penalties will be imposed under §§ 6721 and 6722 for failure to file correct information returns with the Service or to furnish correct statements to the payors with respect to whom information report- ing is required under § 6050S (or § 6050H for those loans secured by real property the proceeds from which are used to pay the costs of postsecondary education). Furthermore, even after the regulations are adopted, no penalties will be imposed under §§ 6721 and 6722 for failure to file correct information returns or furnish cor- rect statements for 1998 as required by § 6050S or § 6050H if the payee made a good faith effort to file information re- turns and furnish statements in accor- dance with this notice. K. Request for Comments. The Conference Report accompanying the Act states the following, “The confer- ees expect that the Secretary of Treasury will issue regulations setting forth report- ing procedures that will facilitate the ad- ministration of this provision. Specifi- cally, such regulations should require lenders separately to report to borrowers the amount of interest that constitutes de- ductible student loan interest (i.e.,interest on a student loan during the first 60 months in which interest payments are re- quired). In this regard, the regulations should include a method for borrower cer- tification to a lender that the loan pro- ceeds are being used to pay for qualified higher education expenses.” H.R. Conf. Rep. No. 220, 105 Cong., 1st Sess. at 368 (1997). Treasury and the Service invite taxpayers to submit comments on how regulations could be drafted in accor- dance with the legislative history. In par- ticular, comments are requested on how parties receiving interest are to determine whether a payment of interest on a student loan has been made during the first 60 months in which interest payments are re- quired and on how much of a payment should be treated as interest, especially where interest has been capitalized. Comments are requested by April 30, 1998. An original and eight copies of written comments should be sent to: Internal Revenue Service Attn: CC:DOM:CORP:R Room 5228 (IT&A:Br1) P.O. Box 7604 Ben Franklin Station Washington, DC 20044, or hand delivered between the hours of 8:00 a.m. and 5:00 p.m. to: Courier’s Desk Internal Revenue Service Attn: CC:DOM:CORP:R Room 5228 (IT&A:Br1) 1111 Constitution Ave., NW Washington, DC Alternatively, taxpayers may submit com- ments electronically via the Internet by selecting the “Tax Regs” option on the IRS Home Page, or by submitting com- ments directly to http://www.irs.ustreas. gov/prod/tax_regs/comments.html (the IRS Internet site). All comments will be available for public inspection and copy- ing in their entirety. DRAFTING INFORMATION The principal author of this notice is John McGreevy of the Office of the As- sistant Chief Counsel (Income Tax and Accounting). For further information re- garding information reporting, contact Mr. McGreevy on (202) 622-4910 (not a toll-free call) or, regarding the deduction, call John Moriarty on (202) 622-4950 (not a toll-free call). 26 CFR 601.601: Rules and regulations. (Also Part I, § 1397E) Rev. Proc. 98–9 SECTION 1. PURPOSE This revenue procedure sets forth the maximum face amount of Qualified Zone Academy Bonds (“Bond” or “Bonds”) that may be issued for each State during 1998. For this purpose “State” includes the District of Columbia and the posses- sions of the United States. SECTION 2. BACKGROUND Section 226 of the Tax Relief Act of 1997, Pub. L. 105–34, 111 Stat. 788 January 20, 1998561998–3 I.R.B. (1997), added § 1397E to the Internal Rev- enue Code to provide a credit to holders of Bonds under certain circumstances so that the Bonds generally can be issued without discount or interest. Ninety-five percent of Bond proceeds are to be used for qualified purposes, as defined by § 1397E(d)(5), with respect to a qualified zone academy, as defined by § 1397E(d)(4). The aggregate amount of Bonds that may be issued for the States is limited to $400 million for 1998 and $400 million for 1999 (the “national limitation”). This amount is to be allocated among the States by the Secretary on the basis of their respective populations below the poverty level (as defined by the Office of Management and Budget). This amount is further allocated by the State to quali- fied zone academies within the State or possession. AState may carry forward to the next calendar year any amount of an allocation of the national limitation for a calendar year that is in excess of the amount of Bonds issued during that cal- endar year that are designated with re- spect to qualified academies within the State. SECTION 3. SCOPE This revenue procedure applies to Bonds issued under § 1397E during 1998. SECTION 4. NATIONAL QUALIFIED ZONE ACADEMY BOND LIMITATION FOR 1998 The total face amount of Bonds that may be issued in 1998 is $400 million. This amount is allocated among the States as follows: 1998–3 I.R.B57January 20, 1998 MAXIMUM FACE AMOUNTOF BONDS THATMAYBE ISSUED DURING 1998 STATE(thousands of dollars) ALABAMA$6,128 ALASKA556 ARIZONA10,094 ARKANSAS4,625 CALIFORNIA56,360 COLORADO4,243 CONNECTICUT4,037 DELAWARE649 DISTRICTOF COLUMBIA1,339 FLORIDA20,981 GEORGIA11,299 HAWAII1,463 IDAHO1,442 ILLINOIS14,718 INDIANA4,408 IOWA2,874 KANSAS2,956 KENTUCKY6,777 LOUISIANA8,992 MAINE1,390 MARYLAND5,376 MASSACHUSETTS6,406 MICHIGAN11,000 MINNESOTA4,717 MISSISSIPPI5,922 MISSOURI 5,150 MONTANA1,596 NEBRASKA1,741 MAXIMUM FACE AMOUNTOF BONDS THATMAYBE ISSUED DURING 1998 STATE(thousands of dollars) NEVADA1,370 NEWHAMPSHIRE752 NEWJERSEY7,478 NEWMEXICO4,861 NEWYORK31,497 NORTH CAROLINA9,115 NORTH DAKOTA711 OHIO14,667 OKLAHOMA5,727 OREGON3,934 PENNSYLVANIA14,152 RHODE ISLAND1,071 SOUTH CAROLINA4,964 SOUTH DAKOTA845 TENNESSEE9,043 TEXAS32,753 UTAH1,576 VERMONT762 VIRGINIA8,188 WASHINGTON6,860 WESTVIRGINIA3,327 WISCONSIN4,738 WYOMING597 AMERICAN SAMOA350 GUAM227 NORTHERN MARIANAS268 PUERTO RICO22,659 VIRGIN ISLANDS268 January 20, 1998581998–3 I.R.B. SECTION 6. EFFECTIVE DATE This revenue procedure applies to Bonds issued after December 31, 1997. DRAFTING INFORMATION The principal author of this revenue procedure is Timothy L. Jones of the Of- fice of Assistant Chief Counsel (Financial Institutions & Products). For further in- formation regarding this revenue proce- dure contact Mr. Jones on (202) 622-3980 (not a toll free call). 1998–3 I.R.B59January 20, 1998 Notice of Proposed Rulemaking Deposits of Excise Taxes REG–102894–97 AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed rulemak- ing by cross-reference to temporary regu- lations. SUMMARY: In T.D. 8740, page 4, the IRS is issuing temporary regulations re- lating to deposits of excise taxes. The temporary regulations contain rules relat- ing to the availability of the safe harbor deposit rule based on look-back quarter li- ability and to floor stocks taxes. The text of those temporary regulations also serves as the text of these proposed regulations. DATES: Written comments and requests for a public hearing must be received by March 30, 1998. ADDRESSES: Send submissions to: CC:DOM:CORP:R (REG–102894–97), room 5226, Internal Revenue Service, POB 7604, Ben Franklin Station, Wash- ington, DC 20044. Submissions may be hand delivered between the hours of 8 a.m. and 5 p.m. to: CC:DOM:CORP:R (REG–102894–97), Courier’s Desk, In- ternal Revenue Service, 1111 Constitution Avenue NW, Washington, DC. Alterna- tively, taxpayers may submit comments electronically via the Internet by selecting the “Tax Regs” option on the IRS Home Page, or by submitting comments directly to the IRS Internet site at http://www.irs. ustreas.gov/prod/tax_regs/comments.html. FOR FURTHER INFORMATION CON- TACT: Concerning submissions, the Regulations Unit, (202) 622-7180; con- cerning the regulations, Ruth Hoffman, (202) 622-3130 (not toll-free numbers). SUPPLEMENTARYINFORMATION: Background T.D. 8740 amends the Excise Tax Pro- cedural Regulations (26 CFR part 40). The temporary regulations contain rules relating to the availability of the safe har- bor deposit rule based on look-back quar- ter liability and to floor stocks taxes. The text of those temporary regulations also serves as the text of these proposed regulations. The preamble to the tempo- rary regulations explains the temporary regulations. Special Analyses It has been determined that this notice of proposed rulemaking is not a signifi- cant regulatory action as defined in EO 12866. Therefore, a regulatory assess- ment is not required. It also has been de- termined that section 553(b) of the Ad- ministrative Procedure Act (5 U.S.C. chapter 5) does not apply to these regula- tions and, because these regulations do not impose on small entities a collection of information requirement, the Regula- tory Flexibility Act (5 U.S.C. chapter 6) does not apply. Therefore, a Regulatory Flexibility Analysis is not required. Pur- suant to section 7805(f) of the Internal Revenue Code, this notice of proposed rulemaking will be submitted to the Chief Counsel for Advocacy of the Small Busi- ness Administration for comment on its impact on small business. Comments and Requests for a Public Hearing Before these proposed regulations are adopted as final regulations, considera- tion will be given to any written com- ments (a signed original and eight (8) copies) that are submitted timely to the IRS. All comments will be available for public inspection and copying. Apublic hearing may be scheduled if requested in writing by any person that timely submits written comments. If a public hearing is scheduled, notice of the date, time, and place for the hearing will be published in the Federal Register. Drafting Information The principal author of these regula- tions is Ruth Hoffman, Office of Assistant Chief Counsel (Passthroughs and Special Industries). However, other personnel from the IRS and Treasury Department participated in their development. ***** Proposed Amendments to the Regulations Accordingly, 26 CFR part 40 is pro- posed to be amended as follows: PART40—EXCISE TAX PROCEDURALREGULATIONS Paragraph 1. The authority citation for part 40 continues to read in part as fol- lows: Authority: 26 U.S.C. 7805 * * * Par. 2. In §40.0–1, paragraph (a) is amended by revising the second sentence to read as follows: §40.0–1 Introduction. (a) * * * The regulations set forth ad- ministrative provisions relating to the ex- cise taxes imposed by chapters 31, 32, 33, 34, 36, 38, and 39 (except for the chapter 32 tax imposed by section 4181 (firearms tax) and the chapter 36 taxes imposed by sections 4461 (harbor maintenance tax) and 4481 (heavy vehicle use tax)), and to floor stocks taxes imposed on articles subject to any of these taxes. * * * ***** Par. 3. In §40.6011(a)–1, add para- graph (a)(2)(iii) to read as follows: §40.6011(a)–1 Returns. (a) * * * (2) * * * (iii) Floor stocks tax return. [The text of this proposed paragraph is the same as the text of §40.6011(a)– 1T(a)(2)(iii) published in T.D. 8740]. Par. 4. Section 40.6302(c)–1 is amended as follows: 1. Paragraph (c)(2)(iv) is added. 2. Paragraph (f)(1) is amended by adding a sentence to the end of the para- graph. The additions read as follows: §40.6302(c)–1 Use of Government depositaries. ***** (c) * * * (2) * * * (iv) Modification for new or reinstated taxes. [The text of this proposed paragraph is the same as the text of §40.6302(c)– 1T(c)(2)(iv) published in T.D. 8740.] Part IV. Items of General Interest ***** (f) * * * (1) * * * Also, no deposit is re- quired in the case of any floor stocks tax described in §40.0–1(a). ***** Par. 5. In §40.6302(c)–2, add para- graph (b)(2)(iii) to read as follows: §40.6302(c)–2 Special rules for use of Government depositaries under section 4681. ***** (b) * * * (2) * * * (iii) Modification for new chemicals. [The text of this proposed paragraph is the same as the text of §40.6302(c)– 2T(b)(2)(iii) published in T.D. 8740.] ***** Michael P. Dolan, Acting Commissioner of Internal Revenue. (Filed by the Office of the Federal Register on De- cember 24, 1997, 8:45 a.m., and published in the issue of the Federal Register for December 29, 1997, 62 F.R. 67589) Notice of Proposed Rulemaking HIPAA Mental Health Parity Act REG–109704–97 AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed rulemak- ing by cross-reference to temporary regu- lations. SUMMARY: In T.D. 8741, page 6, the IRS is issuing temporary regulations re- lating to mental health parity require- ments imposed on group health plans. These requirements were added to the In- ternal Revenue Code by section 1532 of the Taxpayer Relief Act of 1997. The IRS is issuing the temporary regulations at the same time that the Pension and Welfare Benefits Administration of the U.S. De- partment of Labor and the Health Care Fi- nancing Administration of the U.S. De- partment of Health and Human Services are issuing substantially similar interim final regulations relating to mental health parity requirements added by the Mental Health Parity Act of 1996 to the Em- ployee Retirement Income Security Act of 1974 and the Public Health Service Act. The temporary regulations provide guid- ance to employers and group health plans relating to the new mental health parity requirements. The text of those tempo- rary regulations also serves as the text of these proposed regulations. DATES: Written comments and requests for a public hearing must be received by March 23, 1998. ADDRESSES: Send submissions to: CC:DOM:CORP:R (REG–109704–97), room 5226, Internal Revenue Service, POB 7604, Ben Franklin Station, Wash- ington, DC 20044. Submissions may be hand-delivered between the hours of 8 a.m. and 5 p.m. to: CC:DOM:CORP:R (REG–109704–97), Courier’s Desk, In- ternal Revenue Service, 1111 Constitution Avenue, NW, Washington, DC. Alternatively, taxpayers may submit comments electronically via the Internet by selecting the “Tax Regs” option on the IRS Home Page, or by submitting com- ments directly to the IRS Internet site at: http://www.irs.ustreas.gov/prod/tax_regs/ comments.html FOR FURTHER INFORMATION CON- TACT: Concerning the regulations, Russ Weinheimer, (202) 622-4695; concerning submissions or to request a hearing, Mike Slaughter, 202-622-7180. These are not toll-free numbers. SUPPLEMENTARYINFORMATION: Paperwork Reduction Act The collection of information refer- enced in this notice of proposed rulemak- ing has been submitted to the Office of Management and Budget for review in ac- cordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it dis- plays a valid control number assigned by the Office of Management and Budget. The collection of information is in §54.9812–1T(see T.D. 8741). The col- lection of information is required if a plan wishes to avail itself of an exemption pro- vided under the statute. The likely re- spondents are business or other for-profit institutions, nonprofit institutions, small businesses or organizations, and Taft- Hartley trusts. Responses to this collec- tion of information are required in order to obtain the benefit of being exempt from the mental health parity requirement. Books or records relating to a collec- tion of information must be retained as long as their contents may become mater- ial in the administration of any internal revenue law. Generally tax returns and tax return information are confidential, as required by 26 U.S.C. 6103. Comments on the collection of infor- mation should be sent to the Office of Management and Budget, Attn: Desk Officer for the Department of the Trea- sury, Office of Information and Regula- tory Affairs, Washington, DC 20503, with copies to the Internal Revenue Service, Attn: IRS Reports Clearance Officer, T:FP, Washington, DC 20224. Comments on the collection of information should be received by February 20, 1998. Com- ments are specifically requested concern- ing: — Whether the proposed collection of information is necessary for the proper performance of the functions of the Inter- nal Revenue Service, including whether the information will have practical utility; — The accuracy of the estimated burden associated with the proposed collection of information (see the preamble to the tem- porary regulations published in T.D. 8741); — How to enhance the quality, utility, and clarity of the information to be col- lected; — How to minimize the burden of com- plying with the proposed collection of in- formation, including the application of au- tomated collection techniques or other forms of information technology; and — Estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to provide informa- tion. Background The temporary regulations published in T.D. 8741 add §54.9812-1Tto the Miscel- laneous Excise Tax Regulations. These regulations are being published as part of a joint rulemaking with the Department of Labor and the Department of Health and January 20, 1998601998–3 I.R.B. Human Services (the joint rulemaking). The text of those temporary regulations also serves as the text of these proposed regulations. The preamble to the tempo- rary regulations explains the temporary regulations. Special Analyses Pursuant to sections 603(a) and 605(b) of the Regulatory Flexibility Act, it is hereby certified that the collection of in- formation referenced in this notice of pro- posed rulemaking (see §54.9812–1Tof the temporary regulations published in T.D. 8741) will not have a significant eco- nomic impact on a substantial number of small entities. Employers with 50 or fewer employees are not subject to the law. Moreover, even for employers that are subject to the mental health parity re- quirements, no collection of information is required unless they qualify for and claim the 1% increased cost exemption. Even for employers subject to the law who claim the exemption, the estimated time for each response is 2 minutes. Thus, for example, an employer with 100 employees in its group health plan that claimed the 1% increased cost exemption, that took advantage of the three-month transitional period provided in the tempo- rary regulations and that received 10 re- quests to examine the assumptions used in claiming the exemption would incur a total one-time burden of less than 4 hours. At an estimated cost of $11 per hour, this would result in a one-time cost of less than $44. This is not a significant eco- nomic impact. This regulation is not subject to the Un- funded Mandates Reform Act of 1995 be- cause the regulation is an interpretive reg- ulation. For further information and for analyses relating to the joint rulemaking, see the preamble to the joint rulemaking. Pursuant to section 7805(f) of the Internal Revenue Code, this notice of proposed rulemaking will be submitted to the Chief Counsel for Advocacy of the Small Busi- ness Administration for comment on its impact on small business. Comments and Requests for a Public Hearing Before these proposed regulations are adopted as final regulations, considera- tion will be given to any written com- ments (a signed original and eight (8) copies) that are submitted timely to the IRS. All comments will be available for public inspection and copying. Apublic hearing may be scheduled if requested in writing by a person that timely submits written comments. If a public hearing is scheduled, notice of the date, time, and place for the hearing will be published in the Federal Register. Drafting Information The principal author of these proposed regulations is Russ Weinheimer, Office of the Chief Counsel, Employee Benefits and Exempt Organizations. However, other personnel from the IRS and Trea- sury Department participated in their de- velopment. The proposed regulations, as well as the temporary regulations, have been developed in coordination with per- sonnel from the U.S. Department of Labor and U.S. Department of Health and Human Services. ***** Proposed Amendments to the Regulations Accordingly, 26 CFR part 54 is pro- posed to be amended as follows: PART54—PENSION EXCISE TAXES Paragraph 1. The authority citation for part 54 is amended by adding an entry in numerical order to read as follows: Authority: 26 U.S.C. 7805 * * * Section 54.9812–1 is also issued under 26 U.S.C. 9833. * * * Par. 2. Section 54.9812–1 is added to read as follows: §54.9812–1 Parity in the application of certain limits to mental health benefits. [The text of this proposed section is the same as the text of §54.9812 1Tpublished in T.D. 8741.] Deputy Commissioner of Internal Revenue. (Filed by the Office of the Federal Register on De- cember 19, 1997, 8:45 a.m., and published in the issue of the Federal Register for December 22, 1997, 62 F.R. 66967) 1998–3 I.R.B61January 20, 1998 January 20, 1998621998–3 I.R.B. Revenue rulings and revenue procedures (hereinafter referred to as “rulings”) that have an effect on previous rulings use the following defined terms to de- scribe the effect: Amplified describes a situation where no change is being made in a prior pub- lished position, but the prior position is being extended to apply to a variation of the fact situation set forth therein. Thus, if an earlier ruling held that a principle applied to A, and the new ruling holds that the same principle also applies to B, the earlier ruling is amplified. (Compare with modified, below). Clarified is used in those instances where the language in a prior ruling is being made clear because the language has caused, or may cause, some confu- sion. It is not used where a position in a prior ruling is being changed. Distinguisheddescribes a situation where a ruling mentions a previously published ruling and points out an essen- tial difference between them. Modified is used where the substance of a previously published position is being changed. Thus, if a prior ruling held that a principle applied to Abut not to B, and the new ruling holds that it ap- plies to both Aand B, the prior ruling is modified because it corrects a published position. (Compare with amplified and clarified, above). Obsoleted describes a previously pub- lished ruling that is not considered deter- minative with respect to future transac- tions. This term is most commonly used in a ruling that lists previously published rulings that are obsoleted because of changes in law or regulations. Aruling may also be obsoleted because the sub- stance has been included in regulations subsequently adopted. Revoked describes situations where the position in the previously published rul- ing is not correct and the correct position is being stated in the new ruling. Superseded describes a situation where the new ruling does nothing more than restate the substance and situation of a previously published ruling (or rulings). Thus, the term is used to republish under the 1986 Code and regulations the same position published under the 1939 Code and regulations. The term is also used when it is desired to republish in a single ruling a series of situations, names, etc., that were previously published over a pe- riod of time in separate rulings. If the new ruling does more than restate the substance of a prior ruling, a combination of terms is used. For example, modified and superseded describes a situation where the substance of a previously pub- lished ruling is being changed in part and is continued without change in part and it is desired to restate the valid portion of the previously published ruling in a new ruling that is self contained. In this case the previously published ruling is first modified and then, as modified, is super- seded. Supplemented is used in situations in which a list, such as a list of the names of countries, is published in a ruling and that list is expanded by adding further names in subsequent rulings. After the original ruling has been supplemented several times, a new ruling may be pub- lished that includes the list in the original ruling and the additions, and supersedes all prior rulings in the series. Suspended is used in rare situations to show that the previous published rulings will not be applied pending some future action such as the issuance of new or amended regulations, the outcome of cases in litigation, or the outcome of a Service study. Abbreviations The following abbreviations in current use and for- merly used will appear in material published in the Bulletin. A—Individual. Acq.—Acquiescence. B—Individual. BE—Beneficiary. BK—Bank. B.T.A.—Board of Tax Appeals. C.—Individual. C.B.—Cumulative Bulletin. CFR—Code of Federal Regulations. CI—City. COOP—Cooperative. Ct.D.—Court Decision. CY—County. D—Decedent. DC—Dummy Corporation. DE—Donee. Del. Order—Delegation Order. DISC—Domestic International Sales Corporation. DR—Donor. E—Estate. EE—Employee. E.O.—Executive Order. ER—Employer. ERISA—Employee Retirement Income Security Act. EX—Executor. F—Fiduciary. FC—Foreign Country. FICA—Federal Insurance Contribution Act. FISC—Foreign International Sales Company. FPH—Foreign Personal Holding Company. F.R.—Federal Register. FUTA—Federal Unemployment Tax Act. FX—Foreign Corporation. G.C.M.—Chief Counsel’s Memorandum. GE—Grantee. GP—General Partner. GR—Grantor. IC—Insurance Company. I.R.B.—Internal Revenue Bulletin. LE—Lessee. LP—Limited Partner. LR—Lessor. M—Minor. Nonacq.—Nonacquiescence. O—Organization. P—Parent Corporation. PHC—Personal Holding Company. PO—Possession of the U.S. PR—Partner. PRS—Partnership. PTE—Prohibited Transaction Exemption. Pub. L.—Public Law. REIT—Real Estate Investment Trust. Rev. Proc.—Revenue Procedure. Rev. Proc..—Revenue Ruling. S—Subsidiary. S.P.R.—Statements of Procedral Rules. Stat.—Statutes at Large. T—Target Corporation. T.C.—Tax Court. T.D.—Treasury Decision. TFE—Transferee. TFR—Transferor. T.I.R.—Technical Information Release. TP—Taxpayer. TR—Trust. TT—Trustee. U.S.C.—United States Code. X—Corporation. Y—Corporation. Z—Corporation. Definition of Terms 1998–3 I.R.B63January 20, 1998 1 Acumulative list of all revenue rulings, revenue procedures, Treasury decisions, etc., published in Internal Revenue Bulletins 1997–27 through 1997–52 will be found in Internal Revenue Bulletin 1998–1, dated January 5, 1998. Numerical Finding List 1 Bulletins 1998–1 and 1998–2 Announcements: 98–1, 1998–2 I.R.B. 38 98–2, 1998–2 I.R.B.38 98–3, 1998–2 I.R.B.38 Notices: 98–2, 1998–2 I.R.B. 22 98–4, 1998–2 I.R.B. 25 Revenue Procedures: 98–1, 1998–1 I.R.B. 7 98–2, 1998–1 I.R.B. 74 98–3, 1998–1 I.R.B. 100 98–4, 1998–1 I.R.B. 113 98–5, 1998–1 I.R.B. 155 98–6, 1998–1 I.R.B. 183 98–7, 1998–1 I.R.B. 222 98–8, 1998–1 I.R.B. 225 98–10, 1998–2 I.R.B. 35 Revenue Rulings: 98–1, 1998–2 I.R.B. 5 98–2, 1998–2 I.R.B. 15 98–3, 1998–2 I.R.B. 4 98–4, 1998–2 I.R.B. 18 98–5, 1998–2 I.R.B. 20 January 20, 1998641998–3 I.R.B. Finding List of Current Action on Previously Published Items 1 Bulletins 1998–1 and 1998–2 Revenue Procedures: 97–1 Superseded by 98–1, 1998–1 I.R.B. 7 97–2 Superseded by 98–2, 1998–1 I.R.B. 74 97–3 Superseded by 98–3, 1998–1 I.R.B. 100 97–4 Superseded by 98–4, 1998–1 I.R.B. 113 97–5 Superseded by 98–5, 1998–1 I.R.B. 155 97–6 Superseded by 98–6, 1998–1 I.R.B. 183 97–7 Superseded by 98–7, 1998–1 I.R.B. 222 97–8 Superseded by 98–8, 1998–1 I.R.B. 225 97–21 Superseded by 98–2, 1998–1 I.R.B. 74 97–53 Superseded by 98–3, 1998–1 I.R.B. 100 Revenue Rulings: 75–17 Supplemented and superseded by 98–5, 1998–2 I.R.B. 20 92–19 Supplemented in part by 98–2, 1998–2 I.R.B. 15 1 Acumulative finding list for previously published items mentioned in Internal Revenue Bulletins 1997–27 through 1997–52 will be found in Internal Revenue Bulletin 1998–1, dated January 5, 1998. January 20, 1998651998–3 I.R.B. Notes Notes January 20, 1998661998–3 I.R.B. INTERNAL REVENUE BULLETIN The Introduction on page 3 describes the purpose and content of this publication. The weekly Internal Revenue Bulletin is sold on a yearly subscription basis by the Superintendent of Documents. Current subscribers are notified by the Superintendent of Documents when their subscriptions must be renewed. CUMULATIVE BULLETINS The contents of this weekly Bulletin are consolidated semiannually into a permanent, indexed, Cumulative Bulletin. These are sold on a single copy basis and are not included as part of the subscription to the Internal Revenue Bulletin. Subscribers to the week- ly Bulletin are notified when copies of the Cumulative Bulletin are available. Certain issues of Cumulative Bulletins are out of print and are not available. Persons desiring available Cumulative Bulletins, which are listed on the reverse, may purchase them from the Superintendent of Documents. HOW TO ORDER Check the publications and/or subscription(s) desired on the reverse, complete the order blank, enclose the proper remittance, detach entire page, and mail to the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. Please allow two to six weeks, plus mailing time, for delivery. WE WELCOME COMMENTS ABOUT THE INTERNAL REVENUE BULLETIN If you have comments concerning the format or production of the Internal Revenue Bulletin or suggestions for improving it, we would be pleased to hear from you. You can e-mail us your suggestions or comments through the IRS Internet Home Page (www.irs.ustreas.gov) or write to the IRS Bulletin Unit, T:FP:F:CD, Room 5560, 1111 Constitution Avenue NW, Washington, DC 20224. You can also leave a recorded message 24 hours a day, 7 days a week at 1–800–829–9043.
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