Guidance Clarifying Premium Tax Credit Unaffected by Suspension of Personal Exemption Deduction, 76976-76979 [2020-26200]
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Federal Register / Vol. 85, No. 231 / Tuesday, December 1, 2020 / Rules and Regulations
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 1
[TD 9912]
RIN 1545–BP76
Guidance Clarifying Premium Tax
Credit Unaffected by Suspension of
Personal Exemption Deduction
Internal Revenue Service (IRS),
Treasury.
ACTION: Final regulations.
AGENCY:
This document includes final
regulations under sections 36B and 6011
of the Internal Revenue Code (Code) that
clarify that the reduction of the personal
exemption deduction to zero for taxable
years beginning after December 31,
2017, and before January 1, 2026, does
not affect an individual taxpayer’s
ability to claim the premium tax credit.
These final regulations affect
individuals who claim the premium tax
credit.
DATES: Effective date: These final
regulations are effective on December 1,
2020.
Applicability date: These final
regulations apply to taxable years
ending on or after December 31, 2020.
FOR FURTHER INFORMATION CONTACT:
Suzanne R. Sinno at (202) 317–4718 or
Lisa Mojiri-Azad at (202) 317–4649 (not
toll-free numbers).
SUPPLEMENTARY INFORMATION:
Background and Explanation of
Provisions
SUMMARY:
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I. Overview
This document contains final
amendments to the Income Tax
Regulations (26 CFR part 1) under
sections 36B and 6011 of the Code.
Section 151 of the Code generally
allows a taxpayer to claim a personal
exemption deduction, based on the
exemption amount defined in section
151(d), for the taxpayer, the taxpayer’s
spouse, and any dependents, as defined
in section 152 of the Code. On
December 22, 2017, section 151(d)(5)
was added to the Code by section 11041
of Public Law 115–97, 131 Stat. 2054,
2082, commonly referred to as the Tax
Cuts and Jobs Act (TCJA). Section
151(d)(5)(A) provides that, for taxable
years beginning after December 31,
2017, and before January 1, 2026, ‘‘[t]he
term ‘exemption amount’ means zero.’’
However, section 151(d)(5)(B) provides
that the reduction of the exemption
amount to zero is not taken into account
in determining whether a deduction
under section 151 is allowed or
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allowable to a taxpayer, or whether a
taxpayer is entitled to a deduction
under section 151, for purposes of any
other provision of the Code. The
conference report to the TCJA states that
this provision clarifies that the
reduction of the personal exemption to
zero ‘‘should not alter the operation of
those provisions of the Code which refer
to a taxpayer allowed a deduction . . .
under section 151.’’ See H.R. Rep. No.
115–466 at 203 n.16 (Conf. Rep.) (2017).
Beginning in 2014, under the Patient
Protection and Affordable Care Act,
Public Law 111–148 (124 Stat. 119
(2010)), and the Health Care and
Education Reconciliation Act of 2010,
Public Law 111–152 (124 Stat. 1029
(2010)) (collectively, PPACA), eligible
individuals who purchase coverage
under a qualified health plan through a
Health Insurance Exchange (Exchange)
established under section 1311 of the
PPACA may claim a premium tax credit
under section 36B of the Code. Several
rules relating to the premium tax credit
apply based on whether a taxpayer
properly claims or claimed a personal
exemption deduction under section 151
for the taxpayer, the taxpayer’s spouse,
and any dependents. These rules affect
eligibility for the premium tax credit,
computation of the premium tax credit,
reconciliation of advance credit
payments with the premium tax credit
a taxpayer is allowed for the taxable
year, and income tax return filing
requirements related to the premium tax
credit.
II. Eligibility for, and Computation of,
the Premium Tax Credit
To be eligible for the premium tax
credit, an individual must be an
applicable taxpayer. Under section
36B(c)(1), an applicable taxpayer
generally is a taxpayer whose household
income for the taxable year is at least
100 percent but not more than 400
percent of the Federal poverty line for
the taxpayer’s family size for the taxable
year. A taxpayer’s family size is equal to
the number of individuals in the
taxpayer’s family. Section 1.36B–1(d) of
the Income Tax Regulations provides
the rules for determining the
individuals in a taxpayer’s family.
Section 1.36B–1(d), as currently in
effect, provides that a taxpayer’s family
means the individuals for whom a
taxpayer properly claims a deduction
for a personal exemption under section
151 for the taxable year, and further
provides that family size means the
number of individuals in the family.
Additionally, § 1.36B–2(b)(3) provides
that an individual is not an applicable
taxpayer if another taxpayer may claim
a deduction under section 151 for the
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individual for a taxable year beginning
in the calendar year in which the
individual’s taxable year begins.
Section 36B(c)(2) provides that the
premium tax credit generally is not
allowed for a month with respect to an
individual if for that month the
individual is eligible for minimum
essential coverage other than coverage
in the individual market. However,
under a special eligibility rule in
§ 1.36B–2(c)(4)(i), an individual who
may enroll in minimum essential
coverage because of a relationship to
another person eligible for the coverage
but for whom the other eligible person
does not claim a personal exemption
deduction under section 151 is treated
as eligible for minimum essential
coverage under such coverage only for
months that the related individual is
enrolled in the coverage.
Under section 36B(a), a taxpayer’s
premium tax credit is equal to the
premium assistance credit amount for
the taxable year. Section 36B(b)(1) and
§ 1.36B–3(d) generally provide that the
premium assistance credit amount is the
sum of the premium assistance amounts
for all coverage months in the taxable
year for individuals in the taxpayer’s
family, as defined in § 1.36B–1(d).
III. Reconciliation of Advance Credit
Payments With the Premium Tax Credit
Under section 1412 of the PPACA,
advance payments of the premium tax
credit (advance credit payments) may be
paid directly to issuers of qualified
health plans on behalf of eligible
individuals. The amount of advance
credit payments made on behalf of a
taxpayer in a taxable year is determined
by a number of factors, including
projections of the taxpayer’s household
income and family size for the taxable
year. Under § 1.36B–4, a taxpayer
generally must reconcile all advance
credit payments for coverage of any
member of the taxpayer’s family with
the amount of the premium tax credit
allowed under section 36B.
Section 1.36B–4(a)(1)(ii) provides
allocation rules to reconcile advance
credit payments when a taxpayer’s
family members are enrolled with one
or more individuals who are not
members of the taxpayer’s family. If a
taxpayer enrolls an individual and
another taxpayer claims a personal
exemption deduction for the individual,
the allocation rules in
§ 1.36B(a)(1)(ii)(B) apply for purposes of
computing each taxpayer’s premium tax
credit and reconciling any advance
credit payments. If advance credit
payments are made for coverage of an
individual for whom no taxpayer claims
a personal exemption deduction,
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Federal Register / Vol. 85, No. 231 / Tuesday, December 1, 2020 / Rules and Regulations
§ 1.36B–4(a)(1)(ii)(C) provides that the
taxpayer who attested to the Exchange
to the intention to claim a personal
exemption deduction for the individual
as part of the advance credit payment
eligibility determination for coverage of
the individual must reconcile the
advance credit payments.
notice states that until further guidance
is issued, the interim guidance
described in the notice applies. The
notice also states that the Treasury
Department and the IRS intend to
amend the regulations under sections
36B and 6011 to clarify the application
of section 151(d)(5).
IV. Income Tax Return Filing
Requirements Related to the Premium
Tax Credit
Section 6011 provides the general
rules for filing a return. Section 1.6011–
8 requires a taxpayer who receives the
benefit of advance credit payments in a
taxable year to file an income tax return
for that taxable year to reconcile
advance credit payments with the
taxpayer’s premium tax credit. The
regulation further provides that if
advance credit payments are made for
coverage of an individual for whom no
taxpayer claims a personal exemption
deduction, the taxpayer who attested to
the Exchange to the intention to claim
a personal exemption deduction for the
individual as part of the advance credit
payment eligibility determination for
coverage of the individual must file a
tax return and reconcile the advance
credit payments. Taxpayers who are
required to reconcile advance credit
payments or who claim the premium tax
credit must complete Form 8962,
Premium Tax Credit (PTC), and file it
with their income tax return.
VI. Proposed Regulations
On May 27, 2020, the Treasury
Department and the IRS published a
notice of proposed rulemaking (REG–
124810–19) in the Federal Register (85
FR 31710) under section 36B. The
notice of proposed rulemaking
announced that the regulations
currently in effect would be amended to
reflect the guidance in Notice 2018–84.
Specifically, § 1.36B–1(d), as proposed,
would define the term family to mean
the taxpayer, including both spouses in
the case of a joint return, except for
individuals who qualify as a dependent
of another taxpayer under section 152,
and any other individual for whom the
taxpayer is allowed a personal
exemption deduction and whom the
taxpayer properly reports on the
taxpayer’s income tax return for the
taxable year. Consistent with Notice
2018–84, the proposed regulations
would provide that an individual is
reported on the taxpayer’s income tax
return if the individual’s name and
taxpayer identification number (TIN) are
listed on the taxpayer’s Form 1040
series return. To conform to § 1.36–1(d)
as proposed, §§ 1.36B–2, 1.36B–4, and
1.6011–8 would be amended. These
amendments as proposed would apply
for taxable years ending after the date of
publication of the final regulations in
the Federal Register.
V. Notice 2018–84
On November 5, 2018, the Department
of the Treasury (Treasury Department)
and the IRS issued Notice 2018–84,
2018–45 I.R.B. 768, which provided
interim guidance clarifying that the
reduction of the personal exemption
deduction to zero under section
151(d)(5) does not affect the ability of
individual taxpayers to claim the
premium tax credit. Specifically, the
notice provides that (1) a taxpayer is
considered to have claimed a personal
exemption deduction for himself or
herself for a taxable year if the taxpayer
files an income tax return for the year
and does not qualify as a dependent of
another taxpayer under section 152 for
the year; and (2) a taxpayer is
considered to have claimed a personal
exemption deduction for an individual
other than the taxpayer if the taxpayer
is allowed a personal exemption
deduction for the individual, taking into
account section 151(d)(5)(B), and lists
the individual’s name and taxpayer
identification number (TIN) on the Form
1040, U.S. Individual Income Tax
Return, or Form 1040NR, U.S.
Nonresident Alien Income Tax Return,
the taxpayer files for the year. The
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VII. Final Regulations
No comments responsive to the
subject of the notice of proposed
rulemaking were received. There were
no requests for a public hearing on the
proposed regulations, so no public
hearing was held. Accordingly, the
Treasury Department and the IRS are
finalizing the proposed regulations with
no changes. The final regulations are
applicable for taxable years ending on or
after December 31, 2020. However,
taxpayers may apply the final
regulations for taxable years to which
section 151(d)(5) applies ending before
December 31, 2020. See section
7805(b)(7).
Special Analyses
These final regulations are not subject
to review under section 6(b) of
Executive Order 12866 pursuant to the
Memorandum of Agreement (April 11,
2018) between the Treasury Department
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76977
and the Office of Management and
Budget regarding review of tax
regulations.
Pursuant to the Regulatory Flexibility
Act (5 U.S.C. chapter 6), it is hereby
certified that this final rule will not
have a significant economic impact on
a substantial number of small entities.
This certification is based on the fact
that the final regulations affect
individual taxpayers, not entities.
Accordingly, the Secretary certifies that
the rule will not have a significant
economic impact on a substantial
number of small entities.
Pursuant to section 7805(f), these final
regulations have been submitted to the
Chief Counsel for the Office of
Advocacy of the Small Business
Administration for comment on their
impact on small business (85 FR 31710).
No comments on the notice were
received from the Chief Counsel for the
Office of Advocacy of the Small
Business Administration.
Unfunded Mandates Reform Act
Section 202 of the Unfunded
Mandates Reform Act of 1995 (UMRA)
requires that agencies assess anticipated
costs and benefits and take certain other
actions before issuing a final rule that
includes any Federal mandate that may
result in expenditures in any one year
by a state, local, or tribal government, in
the aggregate, or by the private sector, of
$100 million (updated annually for
inflation). This rule does not include
any Federal mandate that may result in
expenditures by state, local, or tribal
governments, or by the private sector in
excess of that threshold.
Executive Order 13132: Federalism
Executive Order 13132 (entitled
‘‘Federalism’’) prohibits an agency from
publishing any rule that has federalism
implications if the rule either imposes
substantial, direct compliance costs on
state and local governments, and is not
required by statute, or preempts state
law, unless the agency meets the
consultation and funding requirements
of section 6 of the Executive Order. This
final rule does not have federalism
implications and does not impose
substantial direct compliance costs on
state and local governments or preempt
state law within the meaning of the
Executive Order.
Statement of Availability of IRS
Documents
The regulations, notices and other
guidance cited in this preamble are
generally published in the Internal
Revenue Bulletin and are available from
the Superintendent of Documents, U.S.
Government Publishing Office,
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Federal Register / Vol. 85, No. 231 / Tuesday, December 1, 2020 / Rules and Regulations
Washington, DC 20402, or by visiting
the IRS website at www.irs.gov.
Drafting Information
The principal author of these final
regulations is Suzanne R. Sinno of the
Office of Associate Chief Counsel
(Income Tax and Accounting). Other
personnel from the Treasury
Department and the IRS participated in
the development of the regulations.
List of Subjects in 26 CFR Part 1
Income taxes, Reporting and
recordkeeping requirements.
Amendments to the Regulations
Accordingly, 26 CFR part 1 is
amended as follows:
PART 1—INCOME TAXES
Paragraph 1. The authority citation
for part 1 is amended by adding entries
in numerical order to read in part as
follows:
■
Authority: 26 U.S.C. 7805 * * *
Par. 2. Section 1.36B–0 is amended
by:
■ 1. Revising the entries for § 1.36B–1(d)
and (o).
■ 2. Revising the entries for § 1.36B–
2(c)(4)(i) and (e).
■ 3. Revising the entries for § 1.36B–
4(a)(1)(ii)(B) and (C).
■ 4. Revising the entry for § 1.36B–4(c).
The revisions read as follows:
■
§ 1.36B–1
Premium tax credit definitions.
*
*
*
*
*
(d) Family and family size.
(1) In general.
(2) Special rule for tax years to which
section 151(d)(5) applies.
*
*
*
*
*
(o) Applicability dates.
§ 1.36B–2 Eligibility for premium tax credit.
*
*
*
*
*
(c) * * *
(4) * * *
(i) Related individual.
*
*
*
*
*
(e) Applicability dates.
§ 1.36B–4 Reconciling the premium tax
credit with advance credit payments.
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*
*
*
*
*
(a) * * *
(1) * * *
(ii) * * *
(B) Individuals enrolled by a taxpayer and
claimed by another taxpayer.
(C) Responsibility for advance credit
payments for an individual not reported on
any taxpayer’s return.
*
*
*
*
*
(c) Applicability dates.
*
*
*
*
*
Par. 3. Section 1.36B–1 is amended by
1. Redesignating paragraph (d) as
paragraph (d)(1).
■
■
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2. Revising the paragraph heading to
newly designated paragraph (d)(1).
■ 3. Adding paragraph (d)(2).
■ 4. Revising paragraph (o).
The additions and revisions read as
follows:
■
§ 1.36B–1
Premium tax credit definitions.
*
*
*
*
*
(d) Family and family size—(1) In
general. * * *
(2) Special rule for tax years to which
section 151(d)(5) applies. For taxable
years to which section 151(d)(5) applies,
a taxpayer’s family means the taxpayer,
including both spouses in the case of a
joint return, except for individuals who
qualify as a dependent of another
taxpayer under section 152, and any
other individual for whom the taxpayer
is allowed a personal exemption
deduction and whom the taxpayer
properly reports on the taxpayer’s
income tax return for the taxable year.
For purposes of this paragraph (d)(2), an
individual is reported on the taxpayer’s
income tax return if the individual’s
name and taxpayer identification
number (TIN) are listed on the
taxpayer’s Form 1040 series return. See
§ 601.602 of this chapter.
*
*
*
*
*
(o) Applicability dates. (1) Except for
paragraphs (d)(2), (l), and (m) of this
section, this section applies to taxable
years ending after December 31, 2013.
(2) Paragraph (d)(2) of this section
applies to taxable years ending on or
after December 31, 2020.
(3) Paragraphs (l) and (m) of this
section apply to taxable years beginning
after December 31, 2018. Paragraphs (l)
and (m) of § 1.36B–1 as contained in 26
CFR part 1 edition revised as of April 1,
2016, apply to taxable years ending after
December 31, 2013, and beginning
before January 1, 2019.
■ Par. 4. Section 1.36B–2 is amended
by:
■ 1. Revising paragraph (c)(4)(i).
■ 2. Revising the heading for paragraph
(e).
■ 3. Adding paragraph (e)(4).
The revisions and addition read as
follows:
§ 1.36B–2
credit.
Eligibility for premium tax
*
*
*
*
*
(c) * * *
(4) Special eligibility rules—(i)
Related individual. An individual who
may enroll in minimum essential
coverage because of a relationship to
another person eligible for the coverage,
but is not included in the family, as
defined in § 1.36B–1(d), of the other
eligible person, is treated as eligible for
such minimum essential coverage only
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for months that the related individual is
enrolled in the coverage.
*
*
*
*
*
(e) Applicability dates. * * *
(4) Paragraph (c)(4)(i) of this section
applies to taxable years ending on or
after December 31, 2020.
■ Par. 5. Section 1.36B–4 is amended
by:
■ 1. Adding a sentence to the end of
paragraph (a)(1)(ii)(B)(1).
■ 2. Revising paragraphs (a)(1)(ii)(B)(2)
and (a)(1)(ii)(C).
■ 3. Revising the paragraph heading to
paragraph (c) and adding a sentence at
the end.
The additions and revisions read as
follows:
§ 1.36B–4 Reconciling the premium tax
credit with advance credit payments.
(a) * * *
(1) * * *
(ii) * * *
(B) Individual enrolled by a taxpayer
and claimed by another taxpayer—(1) In
general. * * * For taxable years to
which section 151(d)(5) applies, the
claiming taxpayer is the taxpayer who
properly includes the shifting enrollee
in his or her family for the taxable year.
(2) Allocation percentage. The
enrolling taxpayer and claiming
taxpayer may agree on any allocation
percentage between zero and one
hundred percent. If the enrolling
taxpayer and claiming taxpayer do not
agree on an allocation percentage, the
percentage is equal to the number of
shifting enrollees properly included in
the enrolling taxpayer’s family divided
by the number of individuals enrolled
by the enrolling taxpayer in the same
qualified health plan as the shifting
enrollee.
*
*
*
*
*
(C) Responsibility for advance credit
payments for an individual not reported
on any taxpayer’s return. If advance
credit payments are made for coverage
of an individual who is not included in
any taxpayer’s family, as defined in
§ 1.36B–1(d), the taxpayer who attested
to the Exchange to the intention to
include such individual in the
taxpayer’s family as part of the advance
credit payment eligibility determination
for coverage of the individual must
reconcile the advance credit payments.
*
*
*
*
*
(c) Applicability dates. * * * The last
sentence of paragraph (a)(1)(ii)(B)(1),
paragraph (a)(1)(ii)(B)(2), and paragraph
(a)(1)(ii)(C) of this section apply to
taxable years ending on or after
December 31, 2020.
■ Par. 6. Section 1.6011–8 is amended
by revising paragraphs (a) and (b) as
follows:
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§ 1.6011–8 Requirement of income tax
return for taxpayers who claim the premium
tax credit under section 36B.
(a) Requirement of return. Except as
otherwise provided in this paragraph
(a), a taxpayer who receives the benefit
of advance payments of the premium
tax credit (advance credit payments)
under section 36B must file an income
tax return for that taxable year on or
before the due date for the return
(including extensions of time for filing)
and reconcile the advance credit
payments. However, if advance credit
payments are made for coverage of an
individual who is not included in any
taxpayer’s family, as defined in § 1.36B–
1(d), the taxpayer who attested to the
Exchange to the intention to include
such individual in the taxpayer’s family
as part of the advance credit payment
eligibility determination for coverage of
the individual must file a tax return and
reconcile the advance credit payments.
(b) Applicability dates—(1) In general.
Except as provided in paragraph (b)(2)
of this section, paragraph (a) of this
section applies for taxable years ending
on or after December 31, 2020.
(2) Prior periods. Paragraph (a) of this
section as contained in 26 CFR part 1
edition revised as of April 1, 2016,
applies to taxable years ending after
December 31, 2013, and beginning
before January 1, 2017. Paragraph (a) of
this section as contained in 26 CFR part
1 edition revised as of April 1, 2020,
applies to taxable years beginning after
December 31, 2016, and ending before
December 31, 2020.
[FR Doc. C1–2020–25867 Filed 11–30–20; 8:45 am]
BILLING CODE 1301–00–D
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
45 CFR Part 153
[CMS–9913–F]
RIN 0938–AU23
Amendments to the HHS-Operated
Risk Adjustment Data Validation (HHS–
RADV) Under the Patient Protection
and Affordable Care Act’s HHSOperated Risk Adjustment Program
Centers for Medicare &
Medicaid Services (CMS), Department
of Health and Human Services (HHS).
ACTION: Final rule.
AGENCY:
[Docket Number OAG 171; AG Order No.
4911–2020 ]
This final rule adopts certain
changes to the risk adjustment data
validation error estimation methodology
beginning with the 2019 benefit year for
states where the Department of Health
and Human Services (HHS) operates the
risk adjustment program. This rule is
finalizing changes to the HHS–RADV
error estimation methodology, which is
used to calculate adjusted risk scores
and risk adjustment transfers, beginning
with the 2019 benefit year of HHS–
RADV. This rule also finalizes a change
to the benefit year to which HHS–RADV
adjustments to risk scores and risk
adjustment transfers would be applied
beginning with the 2020 benefit year of
HHS–RADV. These policies seek to
further the integrity of HHS–RADV,
address stakeholder feedback, promote
fairness, and improve the predictability
of HHS–RADV adjustments.
DATES: These regulations are effective
on December 31, 2020.
FOR FURTHER INFORMATION CONTACT:
Allison Yadsko, (410) 786–1740; Joshua
Paul, (301) 492–4347; Adrianne
Patterson, (410) 786–0686; and Jaya
Ghildiyal, (301) 492–5149.
SUPPLEMENTARY INFORMATION:
RIN 1105–AB63
I. Background
Manner of Federal Executions
A. Legislative and Regulatory Overview
Correction
In rule document 2020–25867
beginning on page 75846 in the issue of
Friday, November 27, 2020, make the
following correction:
The Patient Protection and Affordable
Care Act (Pub. L. 111–148) was enacted
on March 23, 2010; the Health Care and
Education Reconciliation Act of 2010
(Pub. L. 111–152) was enacted on March
30, 2010. These statutes are collectively
Sunita Lough,
Deputy Commissioner for Services and
Enforcement.
Approved: September 4, 2020.
David J. Kautter,
Assistant Secretary of the Treasury (Tax
Policy).
[FR Doc. 2020–26200 Filed 11–27–20; 11:15 am]
BILLING CODE 4830–01–P
DEPARTMENT OF JUSTICE
Office of the Attorney General
28 CFR Part 26
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On page 75846, in the third column,
in the last line, ‘‘December 24, 2020’’
should read ‘‘December 28, 2020.’’
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SUMMARY:
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76979
referred to as ‘‘PPACA’’ in this final
rule. Section 1343 of the PPACA 1
established a permanent risk adjustment
program to provide payments to health
insurance issuers that attract higherthan-average risk populations, such as
those with chronic conditions, funded
by payments from those that attract
lower-than-average risk populations,
thereby reducing incentives for issuers
to avoid higher-risk enrollees. The
PPACA directs the Secretary of the
Department of Health and Human
Services (Secretary), in consultation
with the states, to establish criteria and
methods to be used in carrying out risk
adjustment activities, such as
determining the actuarial risk of
enrollees in risk adjustment covered
plans within a state market risk pool.2
The statute also provides that the
Secretary may utilize criteria and
methods similar to the ones utilized
under Medicare Parts C or D.3
Consistent with section 1321(c)(1) of the
PPACA, the Secretary is responsible for
operating the risk adjustment program
on behalf of any state that elected not
to do so. For the 2014 through 2016
benefit years, all states and the District
of Columbia, except Massachusetts,
participated in the HHS-operated risk
adjustment program. Since the 2017
benefit year, all states and the District of
Columbia have participated in the HHSoperated risk adjustment program.
Data submission requirements for the
HHS-operated risk adjustment program
are set forth at 45 CFR 153.700 through
153.740. Each issuer is required to
establish and maintain an External Data
Gathering Environment (EDGE) server
on which the issuer submits masked
enrollee demographics, claims, and
encounter diagnosis-level data in a
format specified by the Department of
Health and Human Services (HHS).
Issuers must also execute software
provided by HHS on their respective
EDGE servers to generate summary
reports, which HHS uses to calculate the
enrollee-level risk scores to determine
the average plan liability risk scores for
each state market risk pool, the
individual issuers’ plan liability risk
scores, and the transfer amounts by state
market risk pool for the applicable
benefit year.4
Pursuant to 45 CFR 153.350, HHS
performs HHS–RADV to validate the
accuracy of data submitted by issuers
1 42
U.S.C. 18063.
U.S.C. 18063(a) and (b).
3 42 U.S.C. 18063(b).
4 HHS also uses the data issuers submit to their
EDGE servers for the calculation of the high-cost
risk pool payments and charges added to the HHS
risk adjustment methodology beginning with the
2018 benefit year.
2 42
E:\FR\FM\01DER1.SGM
01DER1
Agencies
[Federal Register Volume 85, Number 231 (Tuesday, December 1, 2020)]
[Rules and Regulations]
[Pages 76976-76979]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-26200]
[[Page 76976]]
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DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 1
[TD 9912]
RIN 1545-BP76
Guidance Clarifying Premium Tax Credit Unaffected by Suspension
of Personal Exemption Deduction
AGENCY: Internal Revenue Service (IRS), Treasury.
ACTION: Final regulations.
-----------------------------------------------------------------------
SUMMARY: This document includes final regulations under sections 36B
and 6011 of the Internal Revenue Code (Code) that clarify that the
reduction of the personal exemption deduction to zero for taxable years
beginning after December 31, 2017, and before January 1, 2026, does not
affect an individual taxpayer's ability to claim the premium tax
credit. These final regulations affect individuals who claim the
premium tax credit.
DATES: Effective date: These final regulations are effective on
December 1, 2020.
Applicability date: These final regulations apply to taxable years
ending on or after December 31, 2020.
FOR FURTHER INFORMATION CONTACT: Suzanne R. Sinno at (202) 317-4718 or
Lisa Mojiri-Azad at (202) 317-4649 (not toll-free numbers).
SUPPLEMENTARY INFORMATION: Background and Explanation of Provisions
I. Overview
This document contains final amendments to the Income Tax
Regulations (26 CFR part 1) under sections 36B and 6011 of the Code.
Section 151 of the Code generally allows a taxpayer to claim a
personal exemption deduction, based on the exemption amount defined in
section 151(d), for the taxpayer, the taxpayer's spouse, and any
dependents, as defined in section 152 of the Code. On December 22,
2017, section 151(d)(5) was added to the Code by section 11041 of
Public Law 115-97, 131 Stat. 2054, 2082, commonly referred to as the
Tax Cuts and Jobs Act (TCJA). Section 151(d)(5)(A) provides that, for
taxable years beginning after December 31, 2017, and before January 1,
2026, ``[t]he term `exemption amount' means zero.'' However, section
151(d)(5)(B) provides that the reduction of the exemption amount to
zero is not taken into account in determining whether a deduction under
section 151 is allowed or allowable to a taxpayer, or whether a
taxpayer is entitled to a deduction under section 151, for purposes of
any other provision of the Code. The conference report to the TCJA
states that this provision clarifies that the reduction of the personal
exemption to zero ``should not alter the operation of those provisions
of the Code which refer to a taxpayer allowed a deduction . . . under
section 151.'' See H.R. Rep. No. 115-466 at 203 n.16 (Conf. Rep.)
(2017).
Beginning in 2014, under the Patient Protection and Affordable Care
Act, Public Law 111-148 (124 Stat. 119 (2010)), and the Health Care and
Education Reconciliation Act of 2010, Public Law 111-152 (124 Stat.
1029 (2010)) (collectively, PPACA), eligible individuals who purchase
coverage under a qualified health plan through a Health Insurance
Exchange (Exchange) established under section 1311 of the PPACA may
claim a premium tax credit under section 36B of the Code. Several rules
relating to the premium tax credit apply based on whether a taxpayer
properly claims or claimed a personal exemption deduction under section
151 for the taxpayer, the taxpayer's spouse, and any dependents. These
rules affect eligibility for the premium tax credit, computation of the
premium tax credit, reconciliation of advance credit payments with the
premium tax credit a taxpayer is allowed for the taxable year, and
income tax return filing requirements related to the premium tax
credit.
II. Eligibility for, and Computation of, the Premium Tax Credit
To be eligible for the premium tax credit, an individual must be an
applicable taxpayer. Under section 36B(c)(1), an applicable taxpayer
generally is a taxpayer whose household income for the taxable year is
at least 100 percent but not more than 400 percent of the Federal
poverty line for the taxpayer's family size for the taxable year. A
taxpayer's family size is equal to the number of individuals in the
taxpayer's family. Section 1.36B-1(d) of the Income Tax Regulations
provides the rules for determining the individuals in a taxpayer's
family. Section 1.36B-1(d), as currently in effect, provides that a
taxpayer's family means the individuals for whom a taxpayer properly
claims a deduction for a personal exemption under section 151 for the
taxable year, and further provides that family size means the number of
individuals in the family. Additionally, Sec. 1.36B-2(b)(3) provides
that an individual is not an applicable taxpayer if another taxpayer
may claim a deduction under section 151 for the individual for a
taxable year beginning in the calendar year in which the individual's
taxable year begins.
Section 36B(c)(2) provides that the premium tax credit generally is
not allowed for a month with respect to an individual if for that month
the individual is eligible for minimum essential coverage other than
coverage in the individual market. However, under a special eligibility
rule in Sec. 1.36B-2(c)(4)(i), an individual who may enroll in minimum
essential coverage because of a relationship to another person eligible
for the coverage but for whom the other eligible person does not claim
a personal exemption deduction under section 151 is treated as eligible
for minimum essential coverage under such coverage only for months that
the related individual is enrolled in the coverage.
Under section 36B(a), a taxpayer's premium tax credit is equal to
the premium assistance credit amount for the taxable year. Section
36B(b)(1) and Sec. 1.36B-3(d) generally provide that the premium
assistance credit amount is the sum of the premium assistance amounts
for all coverage months in the taxable year for individuals in the
taxpayer's family, as defined in Sec. 1.36B-1(d).
III. Reconciliation of Advance Credit Payments With the Premium Tax
Credit
Under section 1412 of the PPACA, advance payments of the premium
tax credit (advance credit payments) may be paid directly to issuers of
qualified health plans on behalf of eligible individuals. The amount of
advance credit payments made on behalf of a taxpayer in a taxable year
is determined by a number of factors, including projections of the
taxpayer's household income and family size for the taxable year. Under
Sec. 1.36B-4, a taxpayer generally must reconcile all advance credit
payments for coverage of any member of the taxpayer's family with the
amount of the premium tax credit allowed under section 36B.
Section 1.36B-4(a)(1)(ii) provides allocation rules to reconcile
advance credit payments when a taxpayer's family members are enrolled
with one or more individuals who are not members of the taxpayer's
family. If a taxpayer enrolls an individual and another taxpayer claims
a personal exemption deduction for the individual, the allocation rules
in Sec. 1.36B(a)(1)(ii)(B) apply for purposes of computing each
taxpayer's premium tax credit and reconciling any advance credit
payments. If advance credit payments are made for coverage of an
individual for whom no taxpayer claims a personal exemption deduction,
[[Page 76977]]
Sec. 1.36B-4(a)(1)(ii)(C) provides that the taxpayer who attested to
the Exchange to the intention to claim a personal exemption deduction
for the individual as part of the advance credit payment eligibility
determination for coverage of the individual must reconcile the advance
credit payments.
IV. Income Tax Return Filing Requirements Related to the Premium Tax
Credit
Section 6011 provides the general rules for filing a return.
Section 1.6011-8 requires a taxpayer who receives the benefit of
advance credit payments in a taxable year to file an income tax return
for that taxable year to reconcile advance credit payments with the
taxpayer's premium tax credit. The regulation further provides that if
advance credit payments are made for coverage of an individual for whom
no taxpayer claims a personal exemption deduction, the taxpayer who
attested to the Exchange to the intention to claim a personal exemption
deduction for the individual as part of the advance credit payment
eligibility determination for coverage of the individual must file a
tax return and reconcile the advance credit payments. Taxpayers who are
required to reconcile advance credit payments or who claim the premium
tax credit must complete Form 8962, Premium Tax Credit (PTC), and file
it with their income tax return.
V. Notice 2018-84
On November 5, 2018, the Department of the Treasury (Treasury
Department) and the IRS issued Notice 2018-84, 2018-45 I.R.B. 768,
which provided interim guidance clarifying that the reduction of the
personal exemption deduction to zero under section 151(d)(5) does not
affect the ability of individual taxpayers to claim the premium tax
credit. Specifically, the notice provides that (1) a taxpayer is
considered to have claimed a personal exemption deduction for himself
or herself for a taxable year if the taxpayer files an income tax
return for the year and does not qualify as a dependent of another
taxpayer under section 152 for the year; and (2) a taxpayer is
considered to have claimed a personal exemption deduction for an
individual other than the taxpayer if the taxpayer is allowed a
personal exemption deduction for the individual, taking into account
section 151(d)(5)(B), and lists the individual's name and taxpayer
identification number (TIN) on the Form 1040, U.S. Individual Income
Tax Return, or Form 1040NR, U.S. Nonresident Alien Income Tax Return,
the taxpayer files for the year. The notice states that until further
guidance is issued, the interim guidance described in the notice
applies. The notice also states that the Treasury Department and the
IRS intend to amend the regulations under sections 36B and 6011 to
clarify the application of section 151(d)(5).
VI. Proposed Regulations
On May 27, 2020, the Treasury Department and the IRS published a
notice of proposed rulemaking (REG-124810-19) in the Federal Register
(85 FR 31710) under section 36B. The notice of proposed rulemaking
announced that the regulations currently in effect would be amended to
reflect the guidance in Notice 2018-84. Specifically, Sec. 1.36B-1(d),
as proposed, would define the term family to mean the taxpayer,
including both spouses in the case of a joint return, except for
individuals who qualify as a dependent of another taxpayer under
section 152, and any other individual for whom the taxpayer is allowed
a personal exemption deduction and whom the taxpayer properly reports
on the taxpayer's income tax return for the taxable year. Consistent
with Notice 2018-84, the proposed regulations would provide that an
individual is reported on the taxpayer's income tax return if the
individual's name and taxpayer identification number (TIN) are listed
on the taxpayer's Form 1040 series return. To conform to Sec. 1.36-
1(d) as proposed, Sec. Sec. 1.36B-2, 1.36B-4, and 1.6011-8 would be
amended. These amendments as proposed would apply for taxable years
ending after the date of publication of the final regulations in the
Federal Register.
VII. Final Regulations
No comments responsive to the subject of the notice of proposed
rulemaking were received. There were no requests for a public hearing
on the proposed regulations, so no public hearing was held.
Accordingly, the Treasury Department and the IRS are finalizing the
proposed regulations with no changes. The final regulations are
applicable for taxable years ending on or after December 31, 2020.
However, taxpayers may apply the final regulations for taxable years to
which section 151(d)(5) applies ending before December 31, 2020. See
section 7805(b)(7).
Special Analyses
These final regulations are not subject to review under section
6(b) of Executive Order 12866 pursuant to the Memorandum of Agreement
(April 11, 2018) between the Treasury Department and the Office of
Management and Budget regarding review of tax regulations.
Pursuant to the Regulatory Flexibility Act (5 U.S.C. chapter 6), it
is hereby certified that this final rule will not have a significant
economic impact on a substantial number of small entities. This
certification is based on the fact that the final regulations affect
individual taxpayers, not entities. Accordingly, the Secretary
certifies that the rule will not have a significant economic impact on
a substantial number of small entities.
Pursuant to section 7805(f), these final regulations have been
submitted to the Chief Counsel for the Office of Advocacy of the Small
Business Administration for comment on their impact on small business
(85 FR 31710). No comments on the notice were received from the Chief
Counsel for the Office of Advocacy of the Small Business
Administration.
Unfunded Mandates Reform Act
Section 202 of the Unfunded Mandates Reform Act of 1995 (UMRA)
requires that agencies assess anticipated costs and benefits and take
certain other actions before issuing a final rule that includes any
Federal mandate that may result in expenditures in any one year by a
state, local, or tribal government, in the aggregate, or by the private
sector, of $100 million (updated annually for inflation). This rule
does not include any Federal mandate that may result in expenditures by
state, local, or tribal governments, or by the private sector in excess
of that threshold.
Executive Order 13132: Federalism
Executive Order 13132 (entitled ``Federalism'') prohibits an agency
from publishing any rule that has federalism implications if the rule
either imposes substantial, direct compliance costs on state and local
governments, and is not required by statute, or preempts state law,
unless the agency meets the consultation and funding requirements of
section 6 of the Executive Order. This final rule does not have
federalism implications and does not impose substantial direct
compliance costs on state and local governments or preempt state law
within the meaning of the Executive Order.
Statement of Availability of IRS Documents
The regulations, notices and other guidance cited in this preamble
are generally published in the Internal Revenue Bulletin and are
available from the Superintendent of Documents, U.S. Government
Publishing Office,
[[Page 76978]]
Washington, DC 20402, or by visiting the IRS website at www.irs.gov.
Drafting Information
The principal author of these final regulations is Suzanne R. Sinno
of the Office of Associate Chief Counsel (Income Tax and Accounting).
Other personnel from the Treasury Department and the IRS participated
in the development of the regulations.
List of Subjects in 26 CFR Part 1
Income taxes, Reporting and recordkeeping requirements.
Amendments to the Regulations
Accordingly, 26 CFR part 1 is amended as follows:
PART 1--INCOME TAXES
0
Paragraph 1. The authority citation for part 1 is amended by adding
entries in numerical order to read in part as follows:
Authority: 26 U.S.C. 7805 * * *
0
Par. 2. Section 1.36B-0 is amended by:
0
1. Revising the entries for Sec. 1.36B-1(d) and (o).
0
2. Revising the entries for Sec. 1.36B-2(c)(4)(i) and (e).
0
3. Revising the entries for Sec. 1.36B-4(a)(1)(ii)(B) and (C).
0
4. Revising the entry for Sec. 1.36B-4(c).
The revisions read as follows:
Sec. 1.36B-1 Premium tax credit definitions.
* * * * *
(d) Family and family size.
(1) In general.
(2) Special rule for tax years to which section 151(d)(5)
applies.
* * * * *
(o) Applicability dates.
Sec. 1.36B-2 Eligibility for premium tax credit.
* * * * *
(c) * * *
(4) * * *
(i) Related individual.
* * * * *
(e) Applicability dates.
Sec. 1.36B-4 Reconciling the premium tax credit with advance credit
payments.
* * * * *
(a) * * *
(1) * * *
(ii) * * *
(B) Individuals enrolled by a taxpayer and claimed by another
taxpayer.
(C) Responsibility for advance credit payments for an individual
not reported on any taxpayer's return.
* * * * *
(c) Applicability dates.
* * * * *
0
Par. 3. Section 1.36B-1 is amended by
0
1. Redesignating paragraph (d) as paragraph (d)(1).
0
2. Revising the paragraph heading to newly designated paragraph (d)(1).
0
3. Adding paragraph (d)(2).
0
4. Revising paragraph (o).
The additions and revisions read as follows:
Sec. 1.36B-1 Premium tax credit definitions.
* * * * *
(d) Family and family size--(1) In general. * * *
(2) Special rule for tax years to which section 151(d)(5) applies.
For taxable years to which section 151(d)(5) applies, a taxpayer's
family means the taxpayer, including both spouses in the case of a
joint return, except for individuals who qualify as a dependent of
another taxpayer under section 152, and any other individual for whom
the taxpayer is allowed a personal exemption deduction and whom the
taxpayer properly reports on the taxpayer's income tax return for the
taxable year. For purposes of this paragraph (d)(2), an individual is
reported on the taxpayer's income tax return if the individual's name
and taxpayer identification number (TIN) are listed on the taxpayer's
Form 1040 series return. See Sec. 601.602 of this chapter.
* * * * *
(o) Applicability dates. (1) Except for paragraphs (d)(2), (l), and
(m) of this section, this section applies to taxable years ending after
December 31, 2013.
(2) Paragraph (d)(2) of this section applies to taxable years
ending on or after December 31, 2020.
(3) Paragraphs (l) and (m) of this section apply to taxable years
beginning after December 31, 2018. Paragraphs (l) and (m) of Sec.
1.36B-1 as contained in 26 CFR part 1 edition revised as of April 1,
2016, apply to taxable years ending after December 31, 2013, and
beginning before January 1, 2019.
0
Par. 4. Section 1.36B-2 is amended by:
0
1. Revising paragraph (c)(4)(i).
0
2. Revising the heading for paragraph (e).
0
3. Adding paragraph (e)(4).
The revisions and addition read as follows:
Sec. 1.36B-2 Eligibility for premium tax credit.
* * * * *
(c) * * *
(4) Special eligibility rules--(i) Related individual. An
individual who may enroll in minimum essential coverage because of a
relationship to another person eligible for the coverage, but is not
included in the family, as defined in Sec. 1.36B-1(d), of the other
eligible person, is treated as eligible for such minimum essential
coverage only for months that the related individual is enrolled in the
coverage.
* * * * *
(e) Applicability dates. * * *
(4) Paragraph (c)(4)(i) of this section applies to taxable years
ending on or after December 31, 2020.
0
Par. 5. Section 1.36B-4 is amended by:
0
1. Adding a sentence to the end of paragraph (a)(1)(ii)(B)(1).
0
2. Revising paragraphs (a)(1)(ii)(B)(2) and (a)(1)(ii)(C).
0
3. Revising the paragraph heading to paragraph (c) and adding a
sentence at the end.
The additions and revisions read as follows:
Sec. 1.36B-4 Reconciling the premium tax credit with advance credit
payments.
(a) * * *
(1) * * *
(ii) * * *
(B) Individual enrolled by a taxpayer and claimed by another
taxpayer--(1) In general. * * * For taxable years to which section
151(d)(5) applies, the claiming taxpayer is the taxpayer who properly
includes the shifting enrollee in his or her family for the taxable
year.
(2) Allocation percentage. The enrolling taxpayer and claiming
taxpayer may agree on any allocation percentage between zero and one
hundred percent. If the enrolling taxpayer and claiming taxpayer do not
agree on an allocation percentage, the percentage is equal to the
number of shifting enrollees properly included in the enrolling
taxpayer's family divided by the number of individuals enrolled by the
enrolling taxpayer in the same qualified health plan as the shifting
enrollee.
* * * * *
(C) Responsibility for advance credit payments for an individual
not reported on any taxpayer's return. If advance credit payments are
made for coverage of an individual who is not included in any
taxpayer's family, as defined in Sec. 1.36B-1(d), the taxpayer who
attested to the Exchange to the intention to include such individual in
the taxpayer's family as part of the advance credit payment eligibility
determination for coverage of the individual must reconcile the advance
credit payments.
* * * * *
(c) Applicability dates. * * * The last sentence of paragraph
(a)(1)(ii)(B)(1), paragraph (a)(1)(ii)(B)(2), and paragraph
(a)(1)(ii)(C) of this section apply to taxable years ending on or after
December 31, 2020.
0
Par. 6. Section 1.6011-8 is amended by revising paragraphs (a) and (b)
as follows:
[[Page 76979]]
Sec. 1.6011-8 Requirement of income tax return for taxpayers who
claim the premium tax credit under section 36B.
(a) Requirement of return. Except as otherwise provided in this
paragraph (a), a taxpayer who receives the benefit of advance payments
of the premium tax credit (advance credit payments) under section 36B
must file an income tax return for that taxable year on or before the
due date for the return (including extensions of time for filing) and
reconcile the advance credit payments. However, if advance credit
payments are made for coverage of an individual who is not included in
any taxpayer's family, as defined in Sec. 1.36B-1(d), the taxpayer who
attested to the Exchange to the intention to include such individual in
the taxpayer's family as part of the advance credit payment eligibility
determination for coverage of the individual must file a tax return and
reconcile the advance credit payments.
(b) Applicability dates--(1) In general. Except as provided in
paragraph (b)(2) of this section, paragraph (a) of this section applies
for taxable years ending on or after December 31, 2020.
(2) Prior periods. Paragraph (a) of this section as contained in 26
CFR part 1 edition revised as of April 1, 2016, applies to taxable
years ending after December 31, 2013, and beginning before January 1,
2017. Paragraph (a) of this section as contained in 26 CFR part 1
edition revised as of April 1, 2020, applies to taxable years beginning
after December 31, 2016, and ending before December 31, 2020.
Sunita Lough,
Deputy Commissioner for Services and Enforcement.
Approved: September 4, 2020.
David J. Kautter,
Assistant Secretary of the Treasury (Tax Policy).
[FR Doc. 2020-26200 Filed 11-27-20; 11:15 am]
BILLING CODE 4830-01-P