Amounts attributable to employer contributions
Except as otherwise provided in this section, amounts received by an employee through accident or health insurance for personal injuries or sickness shall be included in gross income to the extent such amounts (1) are attributable to contributions by the employer which were not includible in the gross income of the employee, or (2) are paid by the employer.
Amounts expended for medical care
Except in the case of amounts attributable to (and not in excess of) deductions allowed under section 213 (relating to medical, etc., expenses) for any prior taxable year, gross income does not include amounts referred to in subsection (a) if such amounts are paid, directly or indirectly, to the taxpayer to reimburse the taxpayer for expenses incurred by him for the medical care (as defined in section 213(d)) of the taxpayer, his spouse, his dependents (as defined in section 152, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(B) thereof), and any child (as defined in section 152(f)(1)) of the taxpayer who as of the end of the taxable year has not attained age 27. Any child to whom section 152(e) applies shall be treated as a dependent of both parents for purposes of this subsection.
Payments unrelated to absence from work
Pub. L. 98–21, title I, § 122(b)97 Stat. 87 Repealed. , , ]
Accident and health plans
Rules for application of section 213
For purposes of section 213(a) (relating to medical, dental, etc., expenses) amounts excluded from gross income under subsection (c) shall not be considered as compensation (by insurance or otherwise) for expenses paid for medical care.
Self-employed individual not considered an employee
For purposes of this section, the term “employee” does not include an individual who is an employee within the meaning of section 401(c)(1) (relating to self-employed individuals).
Amount paid to highly compensated individuals under a discriminatory self-insured medical expense reimbursement plan
In general
In the case of amounts paid to a highly compensated individual under a self-insured medical reimbursement plan which does not satisfy the requirements of paragraph (2) for a plan year, subsection (b) shall not apply to such amounts to the extent they constitute an excess reimbursement of such highly compensated individual.
Prohibition of discrimination
Nondiscriminatory eligibility classifications
In general
Exclusion of certain employees
Nondiscriminatory benefits
A self-insured medical reimbursement plan does not meet the requirements of subparagraph (B) of paragraph (2) unless all benefits provided for participants who are highly compensated individuals are provided for all other participants.
Highly compensated individual defined
Self-insured medical reimbursement plan
The term “self-insured medical reimbursement plan” means a plan of an employer to reimburse employees for expenses referred to in subsection (b) for which reimbursement is not provided under a policy of accident and health insurance.
Excess reimbursement of highly compensated individual
Certain controlled groups, etc.
All employees who are treated as employed by a single employer under subsection (b), (c), or (m) of section 414 shall be treated as employed by a single employer for purposes of this section.
Regulations
The Secretary shall prescribe such regulations as may be necessary to carry out the provisions of this section.
Time of inclusion
Any amount paid for a plan year that is included in income by reason of this subsection shall be treated as received or accrued in the taxable year of the participant in which the plan year ends.
Sick pay under Railroad Unemployment Insurance Act
Notwithstanding any other provision of law, gross income includes benefits paid under section 2(a) of the Railroad Unemployment Insurance Act for days of sickness; except to the extent such sickness (as determined in accordance with standards prescribed by the Railroad Retirement Board) is the result of on-the-job injury.
Special rule for certain governmental plans
In general
For purposes of subsection (b), amounts paid (directly or indirectly) to a qualified taxpayer from an accident or health plan described in paragraph (2) shall not fail to be excluded from gross income solely because such plan, on or before , provides for reimbursements of health care expenses of a deceased employee’s beneficiary (other than an individual described in paragraph (3)(B)).
Plan described
Qualified taxpayer
Aug. 16, 1954, ch. 73668A Stat. 30Pub. L. 87–792, § 7(e)76 Stat. 829Pub. L. 88–272, title II, § 205(a)78 Stat. 38Pub. L. 94–455, title V, § 505(a)90 Stat. 1566Pub. L. 95–600, title III, § 366(a)92 Stat. 2855Pub. L. 96–222, title I, § 103(a)(13)(B)94 Stat. 213Pub. L. 96–605, title II, § 201(b)(1)94 Stat. 3527Pub. L. 96–613, § 5(b)(1)94 Stat. 3581Pub. L. 97–34, title I95 Stat. 188Pub. L. 97–248, title II, § 202(b)(3)(C)96 Stat. 421Pub. L. 98–21, title I, § 122(b)97 Stat. 87Pub. L. 98–76, title II, § 241(a)97 Stat. 430Pub. L. 98–369, div. A, title IV, § 423(b)(2)98 Stat. 800Pub. L. 99–514, title XI, § 1151(c)(2)100 Stat. 2503Pub. L. 101–140, title II, § 203(a)(1)103 Stat. 830Pub. L. 108–311, title II, § 207(9)118 Stat. 1177Pub. L. 110–458, title I, § 124(a)122 Stat. 5114Pub. L. 111–152, title I, § 1004(d)(1)124 Stat. 1035Pub. L. 113–295, div. A, title II, § 221(a)(16)128 Stat. 4039Pub. L. 114–113, div. Q, title III, § 305(a)129 Stat. 3088Pub. L. 115–141, div. U, title IV, § 401(a)(36)132 Stat. 1186(, ; , , ; , , ; , title XIX, § 1901(c)(2), , , 1803; , title VII, § 701(c)(1), , , 2899; , (C), , ; , , ; , , ; , §§ 103(c)(2), 111(b)(4), , , 194; , , ; , , ; , , ; , , ; , title XIII, § 1301(j)(9), , , 2658; , , ; , , ; , , ; , , ; , , ; –(c), , ; , , .)
Editorial Notes
References in Text
section 352(a) of Title 45Section 2(a) of the Railroad Unemployment Insurance Act, referred to in subsec. (i), is classified to , Railroads.
Amendments
Pub. L. 115–1412018—Subsec. (h)(7)(B). substituted “subparagraph (A))” for “subparagraph (A)” in introductory provisions.
Pub. L. 114–113, § 305(a)2015—Subsec. (j)(1). , substituted “a qualified taxpayer” for “the taxpayer” and “deceased employee’s beneficiary (other than an individual described in paragraph (3)(B))” for “deceased plan participant’s beneficiary”.
Pub. L. 114–113, § 305(c)(1)Subsec. (j)(2). , inserted “or established by or on behalf of a State or political subdivision thereof” after “public retirement system” in introductory provisions.
Pub. L. 114–113, § 305(c)(2)Subsec. (j)(2)(B). , inserted “or 501(c)(9)” after “section 115”.
Pub. L. 114–113, § 305(b)Subsec. (j)(3). , added par. (3).
Pub. L. 113–2952014—Subsec. (f). struck out “or (d)” after “subsection (c)”.
Pub. L. 111–1522010—Subsec. (b). substituted “his dependents” for “and his dependents” and inserted “, and any child (as defined in section 152(f)(1)) of the taxpayer who as of the end of the taxable year has not attained age 27” after “thereof)”.
Pub. L. 110–4582008—Subsec. (j). added subsec. (j).
Pub. L. 108–3112004—Subsecs. (b), (c)(1). inserted “, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(B) thereof” after “section 152”.
Pub. L. 101–140Pub. L. 99–514, § 1151(c)(2)1989—Subsecs. (h), (i). amended subsecs. (h) and (i) to read as if amendments by , had not been enacted, see 1986 Amendment note below.
Pub. L. 99–514, § 1301(j)(9)Pub. L. 98–211986—Subsec. (d)(5)(C). , which directed that subpar. (C) be amended by substituting “section 7703(a)” for “section 143(a)”, could not be executed because subsec. (d) was previously repealed by . See 1983 Amendment note below.
Pub. L. 99–514, § 1151(c)(2)Subsecs. (h), (i). , redesignated subsec. (i) as (h) and struck out former subsec. (h) which related to amount paid to highly compensated individuals under a discriminatory self-insured medical expense reimbursement plan.
Pub. L. 98–3691984—Subsec. (b). inserted “Any child to whom section 152(e) applies shall be treated as a dependent of both parents for purposes of this subsection.”
Pub. L. 98–211983—Subsec. (d). struck out subsec. (d) which provided that no deduction or credit would be allowed with respect to any expenditure which is properly associated with any amount excluded from gross income under subsec. (a).
Pub. L. 98–76Subsec. (i). added subsec. (i).
Pub. L. 97–2481982—Subsec. (b). substituted “section 213(d)” for “section 213(e)”.
Pub. L. 97–34, § 103(c)(2)1981—Subsec. (d)(3). , substituted “this subsection and section 221” for “this subsection” in parenthetical provision.
Pub. L. 97–34, § 111(b)(4)Subsec. (h)(3)(B)(v). , substituted “section 911(d)(2)” for “section 911(b)”.
Pub. L. 96–222, § 103(a)(13)(B)1980—Subsec. (h)(3)(A). , substituted “highly compensated individuals” for “highly compensated participants”.
Pub. L. 96–222, § 103(a)(13)(C)Subsec. (h)(7)(A). , substituted “highly compensated individuals but not to all other participants (or which otherwise fails to satisfy the requirements of paragraph (2)(B))” for “a highly compensated individual but not to a broad cross-section of employees”.
Pub. L. 96–613Pub. L. 96–605Subsec. (h)(8). and made identical amendments by substituting in heading “controlled groups, etc.” for “controlled groups”, and by substituting in text “subsection (b), (c), or (m) of section 414” for “subsection (b) or (c) of section 414”.
Pub. L. 95–600, § 7011978—Subsec. (d)(4). (c)(1), redesignated par. (5) as (4). Former par. (4) redesignated (5)(A) and (C).
Pub. L. 95–600, § 701(c)(1)Subsec. (d)(5). , added heading and subpar. (B), redesignated former par. (4) as subpars. (A) and (C), adding subpar. (C) heading and substituting “section 143(a)” for “section 143”; and redesignated former par. (6) as subpar. (D), inserting “defined” in heading.
Pub. L. 95–600, § 701(c)(1)Subsec. (d)(6), (7). , redesignated par. (7) as (6). Former par. (6) redesignated (5)(D).
Pub. L. 95–600, § 366(a)Subsec. (h). , added subsec. (h).
Pub. L. 94–455, § 505(a)section 72 of this title1976—Subsec. (d). , substituted provisions relating to an exclusion of up to $5,200 a year for taxpayers retiring on disability prior to age 65; dollar-for-dollar phase out of exclusion for adjusted annual gross income (including disability income) in excess of $15,000; requirement that married couple must file joint return; defined “permanent and total disability” and “joint return”; and inserted special rule for coordination with for provisions relating to wage continuation plans.
Pub. L. 94–455, § 1901(c)(2)Subsec. (e)(2). , struck out “a territory” after “of a State”.
Pub. L. 88–2721964—Subsec. (d). substituted provisions stating that “The preceding sentence shall not apply to amounts attributable to the first 30” days if the amounts exceed 75 percent of regular weekly wages, and if they do not exceed said 75 percent, the first sentence of this subsection shall not apply to the extent the amounts exceed $75 weekly and shall not apply to amounts attributable to the first 7 calendar days unless the employee is hospitalized for injury or sickness for at least 1 day in such period, for provisions stating that said “preceding sentence” did not apply in cases of sickness, to amounts attributable to the first 7 days unless the employee was hospitalized for sickness for at least 1 day during such period.
Pub. L. 87–7921962—Subsec. (g). added subsec. (g).
Statutory Notes and Related Subsidiaries
Effective Date of 2015 Amendment
Pub. L. 114–113, div. Q, title III, § 305(d)129 Stat. 3089
Effective Date of 2014 Amendment
Pub. L. 113–295section 221(b) of Pub. L. 113–295section 1 of this titleAmendment by effective , subject to a savings provision, see , set out as a note under .
Effective Date of 2008 Amendment
Pub. L. 110–458, title I, § 124(b)122 Stat. 5115
Effective Date of 2004 Amendment
Pub. L. 108–311section 208 of Pub. L. 108–311section 2 of this titleAmendment by applicable to taxable years beginning after , see , set out as a note under .
Effective Date of 1989 Amendment
Pub. L. 101–140section 1151 of Pub. L. 99–514section 203(c) of Pub. L. 101–140section 79 of this titleAmendment by effective as if included in , see , set out as a note under .
Effective Date of 1986 Amendment
section 1151(c)(2) of Pub. L. 99–514section 1151(k) of Pub. L. 99–514section 79 of this titleAmendment by applicable, with certain qualifications and exceptions, to years beginning after , see , as amended, set out as a note under .
section 1301(j)(9) of Pub. L. 99–514Pub. L. 99–514section 141 of this titleAmendment by applicable to bonds issued after , except as otherwise provided, see sections 1311 to 1318 of , set out as an Effective Date; Transitional Rules note under .
Effective Date of 1984 Amendment
Pub. L. 98–369section 423(d) of Pub. L. 98–369section 2 of this titleAmendment by applicable to taxable years beginning after , see , set out as a note under .
Effective Date of 1983 Amendment
Pub. L. 98–76, title II, § 241(b)97 Stat. 430
Pub. L. 98–21section 122(d) of Pub. L. 98–21section 22 of this titleAmendment by applicable to taxable years beginning after , except that if an individual’s annuity starting date was deferred under subsec. (d)(6) as in effect the day before , such deferral shall end on the first day of such individual’s first taxable year beginning after , see set out as a note under .
Effective Date of 1982 Amendment
Pub. L. 97–248section 202(c) of Pub. L. 97–248section 213 of this titleAmendment by applicable to taxable years beginning after , see , set out as a note under .
Effective Date of 1981 Amendment
Pub. L. 97–34Pub. L. 97–34Amendment by applicable to taxable years beginning after , see sections 103(d) and 115 of , set out as notes under sections 62 and 911, respectively, of this title.
Effective Date of 1980 Amendment
Pub. L. 96–605section 201(c) of Pub. L. 96–605section 5(c) of Pub. L. 96–613section 414 of this titleAmendments by and 96–613 applicable to years ending after , except in the case of a plan in existence on , where amendments applicable to plan years beginning after , see and , set out as a note under .
Pub. L. 96–222Pub. L. 95–600section 201 of Pub. L. 96–222section 32 of this titleAmendment by effective, except as otherwise provided, as if it had been included in the provisions of the Revenue Act of 1978, , to which such amendment relates, see , set out as a note under .
Effective Date of 1978 Amendment
Pub. L. 95–600, title III, § 366(b)92 Stat. 2857Pub. L. 96–222, title I, § 103(a)(13)(D)94 Stat. 213
Pub. L. 95–600, title VII, § 701(c)(3)92 Stat. 2900Pub. L. 99–514, § 2100 Stat. 2095
Effective Date of 1976 Amendment
Pub. L. 94–455, title V, § 505(f)Pub. L. 95–30, title III, § 301(a)91 Stat. 151
section 1901(c)(2) of Pub. L. 94–455section 1901(d) of Pub. L. 94–455section 2 of this titleAmendment by applicable with respect to taxable years beginning after , see , set out as a note under .
Effective Date of 1964 Amendment
Pub. L. 88–272, title II, § 205(b)78 Stat. 38
Effective Date of 1962 Amendment
Pub. L. 87–792section 8 of Pub. L. 87–792section 22 of this titleAmendment by applicable to taxable years beginning after , see , set out as a note under .
Section 1151 of Pub. L. 99–514Nonenforcement of Amendment Made by for Fiscal Year 1990
Pub. L. 101–136section 1151 of Pub. L. 99–514section 528 of Pub. L. 101–136section 89 of this titleNo monies appropriated by to be used to implement or enforce or the amendments made by such section, see , set out as a note under .
Revocation of Election
Pub. L. 95–30, title III, § 301(c)91 Stat. 151Pub. L. 95–600, title VII, § 701(c)(2)(B)92 Stat. 2900Pub. L. 99–514, § 2100 Stat. 2095
Period for Assessing Deficiency
Pub. L. 95–30, title III, § 301(d)91 Stat. 152
Effective Date of Changes in Exclusion for Sick Pay
Pub. L. 95–30, title III, § 301(e)91 Stat. 152Pub. L. 95–600, title VII, § 701(c)(2)(B)92 Stat. 2900Pub. L. 99–514, § 2100 Stat. 2095
Special Rule for Existing Permanent and Total Disability Cases
Pub. L. 94–455, title V, § 505(c)90 Stat. 1567Pub. L. 95–30, title III, § 301(b)(1)91 Stat. 151Pub. L. 95–600, title VII, § 701(c)(2)(A)92 Stat. 2900Pub. L. 99–514, § 2100 Stat. 2095
Special Rule for Coordination With Section 72 of This Title
Pub. L. 94–455, title V, § 505(d)90 Stat. 1568Pub. L. 95–30, title III, § 301(b)(3)91 Stat. 151Pub. L. 99–514, § 2100 Stat. 2095