Treasury Regulations (26 C.F.R.)

26 CFR § 54.9802-2

Special rules for certain church plans.

Official textecfr.govlast amended

# (a)

Exception for certain church plans—(1) Church plans in general. A church plan described in paragraph (b) of this section is not treated as failing to meet the requirements of section 9802 or § 54.9802-1 solely because the plan requires evidence of good health for coverage of individuals under plan provisions described in paragraph (b)(2) or (3) of this section.

(2) Health insurance issuers. See sections 2702 and 2721(b)(1)(B) of the Public Health Service Act (42 U.S.C. 300gg-2 and 300gg-21(b)(1)(B)) and 45 CFR 146.121, which require health insurance issuers providing health insurance coverage under a church plan that is a group health plan to comply with nondiscrimination requirements similar to those that church plans are required to comply with under section 9802 and § 54.9802-1 except that those nondiscrimination requirements do not include an exception for health insurance issuers comparable to the exception for church plans under section 9802(c) and this section.

# (b)

Church plans to which this section applies—(1) Church plans with certain coverage provisions in effect on July 15, 1997. This section applies to any church plan (as defined in section 414(e)) for a plan year if, on July 15, 1997 and at all times thereafter before the beginning of the plan year, the plan contains either the provisions described in paragraph (b)(2) of this section or the provisions described in paragraph (b)(3) of this section.

(2) Plan provisions applicable to individuals employed by employers of 10 or fewer employees and self-employed individuals. (i) A plan contains the provisions described in this paragraph (b)(2) if it requires evidence of good health of both—

(A) Any employee of an employer of 10 or fewer employees (determined without regard to section 414(e)(3)(C), under which a church or convention or association of churches is treated as the employer); and

(B) Any self-employed individual.

(ii) A plan does not contain the provisions described in this paragraph (b)(2) if the plan contains only one of the provisions described in this paragraph (b)(2). Thus, for example, a plan that requires evidence of good health of any self-employed individual, but not of any employee of an employer with 10 or fewer employees, does not contain the provisions described in this paragraph (b)(2). Moreover, a plan does not contain the provision described in paragraph (b)(2)(i)(A) of this section if the plan requires evidence of good health of any employee of an employer of fewer than 10 (or greater than 10) employees. Thus, for example, a plan does not contain the provision described in paragraph (b)(2)(i)(A) of this section if the plan requires evidence of good health of any employee of an employer with five or fewer employees.

(3) Plan provisions applicable to individuals who enroll after the first 90 days of initial eligibility. (i) A plan contains the provisions described in this paragraph (b)(3) if it requires evidence of good health of any individual who enrolls after the first 90 days of initial eligibility under the plan.

(ii) A plan does not contain the provisions described in this paragraph (b)(3) if it provides for a longer (or shorter) period than 90 days. Thus, for example, a plan requiring evidence of good health of any individual who enrolls after the first 120 days of initial eligibility under the plan does not contain the provisions described in this paragraph (b)(3).

# (c) Examples.

The rules of this section are illustrated by the following examples:

Example 1.

(i) Facts. A church organization maintains two church plans for entities affiliated with the church. One plan is a group health plan that provides health coverage to all employees (including ministers and lay workers) of any affiliated church entity that has more than 10 employees. The other plan is Plan O, which is a group health plan that is not funded through insurance coverage and that provides health coverage to any employee (including ministers and lay workers) of any affiliated church entity that has 10 or fewer employees and any self-employed individual affiliated with the church (including a self-employed minister of the church). Plan O requires evidence of good health in order for any individual of a church entity that has 10 or fewer employees to be covered and in order for any self-employed individual to be covered. On July 15, 1997 and at all times thereafter before the beginning of the plan year, Plan O has contained all the preceding provisions.

(ii) Conclusion. In this Example 1, because Plan O contains the plan provisions described in paragraph (b)(2) of this section and because those provisions were in the plan on July 15, 1997 and at all times thereafter before the beginning of the plan year, Plan O will not be treated as failing to meet the requirements of section 9802 or § 54.9802-1 for the plan year solely because the plan requires evidence of good health for coverage of the individuals described in those plan provisions.

Example 2.

(i) Facts. A church organization maintains Plan P, which is a church plan that is not funded through insurance coverage and that is a group health plan providing health coverage to individuals employed by entities affiliated with the church and self-employed individuals affiliated with the church (such as ministers). On July 15, 1997 and at all times thereafter before the beginning of the plan year, Plan P has required evidence of good health for coverage of any individual who enrolls after the first 90 days of initial eligibility under the plan.

(ii) Conclusion. In this Example 2, because Plan P contains the plan provisions described in paragraph (b)(3) of this section and because those provisions were in the plan on July 15, 1997 and at all times thereafter before the beginning of the plan year, Plan P will not be treated as failing to meet the requirements of section 9802 or § 54.9802-1 for the plan year solely because the plan requires evidence of good health for coverage of individuals enrolling after the first 90 days of initial eligibility under the plan.

# (d) Applicability date.

This section is applicable to plan years beginning on or after July 1, 2007.

[T.D. 9299, 71 FR 75056, Dec. 13, 2006]

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In this part (40 sections)
  1. 54.6091-1 · Place for filing excise tax returns under section 4980B,…
  2. 54.6107-1 · Tax return preparer must furnish copy of return or claims…
  3. 54.6109-1 · Tax return preparers furnishing identifying numbers for…
  4. 54.6151-1 · Time and place for paying of tax shown on returns.
  5. 54.6694-1 · Section 6694 penalties applicable to tax return preparer.
  6. 54.6694-2 · Penalties for understatement due to an unreasonable…
  7. 54.6694-3 · Penalty for understatement due to willful, reckless, or…
  8. 54.6694-4 · Extension of period of collection when tax return preparer…
  9. 54.6695-1 · Other assessable penalties with respect to the preparation…
  10. 54.6696-1 · Claims for credit or refund by tax return preparers.
  11. 54.7701-1 · Tax return preparer.
  12. 54.9801-1 · Basis and scope.
  13. 54.9801-1T · Basis and scope (temporary).
  14. 54.9801-2 · Definitions.
  15. 54.9801-2T · Definitions (temporary).
  16. 54.9801-3 · Limitations on preexisting condition exclusion period.
  17. 54.9801-4 · Rules relating to creditable coverage.
  18. 54.9801-5 · Evidence of creditable coverage.
  19. 54.9801-6 · Special enrollment periods.
  20. 54.9802-1 · Prohibiting discrimination against participants and…
  21. 54.9802-2 · Special rules for certain church plans.
  22. 54.9802-3T · Additional requirements prohibiting discrimination based…
  23. 54.9802-4 · Special Rule Allowing Integration of Health Reimbursement…
  24. 54.9811-1 · Standards relating to benefits for mothers and newborns.
  25. 54.9812-1 · Parity in mental health and substance use disorder benefits.
  26. 54.9812-2 · Nonquantitative treatment limitation comparative analysis…
  27. 54.9815-1251 · Preservation of right to maintain existing coverage.
  28. 54.9815-2704 · Prohibition of preexisting condition exclusions.
  29. 54.9815-2705 · Prohibiting discrimination against participants and…
  30. 54.9815-2708 · Prohibition on waiting periods that exceed 90 days.
  31. 54.9815-2711 · No lifetime or annual limits.
  32. 54.9815-2712 · Rules regarding rescissions.
  33. 54.9815-2713 · Coverage of preventive health services.
  34. 54.9815-2713T · Coverage of preventive health services (temporary).
  35. 54.9815-2713A · Accommodations in connection with coverage of…
  36. 54.9815-2714 · Eligibility of children until at least age 26.
  37. 54.9815-2715 · Summary of benefits and coverage and uniform glossary.
  38. 54.9815-2715A1 · Transparency in coverage—definitions.
  39. 54.9815-2715A2 · Transparency in coverage—required disclosures to…
  40. 54.9815-2715A3 · Transparency in coverage—requirements for public…
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