1994 U.S. Tax Ct. LEXIS 53">*53
P1 and P2 are organizations established under
103 T.C. 140">*141 OPINION
Nims,
Petitioners invoked the jurisdiction of this Court, pursuant to section 7428(a), for a declaratory judgment that they are exempt from taxation as "cooperative hospital service organizations" under
The statutory prerequisites for this declaratory judgment action have been satisfied. See sec. 7428(b); Rule 210(c). Specifically, petitioners exhausted their administrative remedies within the Internal Revenue Service, received final adverse determination letters mailed on November1994 U.S. Tax Ct. LEXIS 53">*55 12, 1992, and properly invoked the jurisdiction of this Court by petitions filed on February 11, 1993.
These consolidated cases were submitted to the Court for decision pursuant to Rule 122(a) based upon the pleadings and stipulated administrative records as defined in Rule 210(b)(10). For purposes of this proceeding, we accept the facts and representations contained in the administrative records as true and incorporate them herein by this reference. Rule 217(b)(1).
Trust Fund is a trust organized on April 4, 1975, to serve as a "Medical Malpractice Risk Management Trust Fund" as 103 T.C. 140">*142 defined in
1994 U.S. Tax Ct. LEXIS 53">*56 Trust Fund members, numbering approximately 23 hospitals, are qualified members of the Florida Hospital Association and are either government-run hospitals as described in
Trust Fund is governed by an agreement dated April 1, 1985, entitled "Florida Hospital Trust Fund Mutual Covenants -- Claims Made" (Trust Fund agreement). The Trust Fund agreement sets forth the terms under which member hospitals agree to pool their resources to self-insure within certain limits against liability arising from the death or injury of a person (including patients) due to the rendering or failure to render specified professional services. In particular, insurance is provided on a claims-made basis with coverage per member up to $ 250,000 per claim with an annual aggregate limit of $ 1 million. In order to obtain such coverage, 103 T.C. 140">*143 each member is required to assume joint and several liability with respect to the obligations of Trust Fund with a right of indemnity against the remaining members based on each member's pro rata share of the obligation. In practice, members pay annual premiums based upon an independent1994 U.S. Tax Ct. LEXIS 53">*57 actuary's projection of Trust Fund's anticipated funding needs. Member premiums are later adjusted, resulting in either an additional assessment or a refund or credit, to reflect Trust Fund's actual loss experience.
The Trust Fund agreement states that Trust Fund will be managed by a service agent pursuant to specified powers and authority as set forth in the agreement. The Trust Fund agreement further provides for the selection of a board of trustees to exercise the rights of the members.
Trust Fund B is a trust organized on April 1, 1985, to serve as a "Medical Malpractice Risk Management Trust Fund" as defined in
Trust Fund B members, numbering approximately 26 hospitals, are qualified members of the Florida Hospital Association and are either government-run hospitals as described in
1994 U.S. Tax Ct. LEXIS 53">*58 Trust Fund B is governed by an agreement dated April 1, 1985, entitled "Florida Hospital Excess Trust Fund B Mutual Covenants -- Claims Made" (Trust Fund B agreement). The Trust Fund B agreement sets forth the terms under which member hospitals agree to pool their resources to self-insure within certain limits against liability arising from the death or injury of a person (including patients) due to the rendering or failure to render specified professional services. The insurance, so-called excess liability coverage, is provided on a claims-made basis with coverage per member up to $ 10 million per claim with an annual aggregate limit of $ 10 million (in excess of a minimum retention of $ 250,000 per claim and an annual aggregate retention of $ 1 million). In order to obtain such coverage, each member is required to assume 103 T.C. 140">*144 joint and several liability with respect to the obligations of Trust Fund B with a right of indemnity against the remaining members based on each member's pro rata share of the obligation. In practice, members pay annual premiums based upon an independent actuary's projection of Trust Fund B's anticipated funding needs. Member premiums are later adjusted, 1994 U.S. Tax Ct. LEXIS 53">*59 resulting in either an additional assessment or a refund or credit, to reflect Trust Fund B's actual loss experience.
The Trust Fund B agreement states that Trust Fund B will be managed by a service agent pursuant to specified powers and authority as set forth in the agreement. The agreement further provides for the selection of a board of trustees to exercise the rights of the members.
Workers' Compensation Fund is a trust organized on September 1, 1977, to serve as a "Group Self-Insurer's Fund" as described in
1994 U.S. Tax Ct. LEXIS 53">*60 Workers' Compensation Fund members, numbering approximately 31 hospitals, are qualified members of the Florida Hospital Association and are either government-run hospitals as described in
103 T.C. 140">*145 Workers' Compensation Fund is governed by an indemnity agreement dated October 1, 1985. The indemnity agreement sets forth the terms under which member hospitals agree to self-insure against liability arising under the Florida Workers' Compensation Act. In order to obtain such coverage, Workers' Compensation Fund members are required to assume joint and several liability with respect to any lawful awards entered against another member by the Division of Workers' Compensation of the Florida Department of Labor and Employment Security. In practice, members pay annual premiums based upon rates prepared by the National Council on Compensation Insurance as mandated by the Florida Department of Labor and Employment Security. Member premiums are later adjusted, resulting in either an additional assessment or a refund or credit, to reflect Workers' Compensation Fund's actual liability.
To qualify1994 U.S. Tax Ct. LEXIS 53">*61 as an organization described in
1994 U.S. Tax Ct. LEXIS 53">*62 103 T.C. 140">*146 In the event respondent determines that an organization does not qualify for exempt status, the organization may (after exhausting its administrative remedies) seek judicial review of the matter. In this regard, section 7428(a) confers jurisdiction on this Court (among others) to make a declaration with respect to the initial qualification of an organization as an organization described in
1994 U.S. Tax Ct. LEXIS 53">*63 It is well established that the scope of our inquiry is limited to the propriety of the reasons given by respondent for denying the organization's application for exempt status.
The parties disagree as to whether petitioners are organized and operated exclusively for exempt purposes. Respondent's final adverse determination letters state in pertinent part:
1994 U.S. Tax Ct. LEXIS 53">*64 This ruling is made for the following reason(s):
You are not a cooperative hospital service organization described in
Petitioners, focusing on the legislative history underlying the statutory provisions in question, contend that respondent erred with respect to each of the alternative determinations set forth above.
The proper disposition of this matter turns largely on the correct interpretation of what are fairly specific statutory provisions. We preface our analysis with a brief review of the historical development of those1994 U.S. Tax Ct. LEXIS 53">*65 provisions.
The law governing the exempt status of cooperative hospital service organizations finds its origin in a 1950 amendment to
(a) An organization operated for the primary purpose of carrying on a trade or business for profit shall not be exempt from taxation under
The legislative history of the feeder organizations provision reveals that it was adopted in part to alleviate concerns that exempt organizations involved in commercial enterprises might enjoy an unfair competitive advantage over taxable businesses operating in the same industry. S. Rept. 2375, 81st Cong., 2d Sess. 28-29, 35 (1950),
In 1952, the Treasury Department adopted sec. 29.101-3(b), Regs. 111,
(b) * * * If a subsidiary organization of a tax-exempt organization would itself be exempt on the ground that its activities are an integral part of 103 T.C. 140">*148 the exempt activities of the parent organization, its exemption will not be lost because, as a matter of accounting between the two organizations, the subsidiary derives a profit from its dealings with its parent organization, for example, a subsidiary organization which is operated for the sole purpose of furnishing electric power used by its parent organization, a tax-exempt educational organization, in carrying on its educational activities. However, the subsidiary organization is not exempt from tax if it is operated for the primary purpose of carrying on a trade or business which would be an unrelated trade or business (that is, unrelated to exempt activities) if regularly carried on by the parent organization. For example, if a subsidiary organization is operated primarily for the purpose of furnishing electric power to1994 U.S. Tax Ct. LEXIS 53">*67 consumers other than its parent organization (and the parent's tax-exempt subsidiary organizations), it is not exempt since such business would be an unrelated trade or business if regularly carried on by the parent organization. Similarly, if the organization is owned by several unrelated exempt organizations, and is operated for the purpose of furnishing electric power to each of them, it is not exempt since such business would be an unrelated trade or business if regularly carried on by any one of the tax-exempt organizations. * * *
For a more detailed history and analysis of this regulation see
Congress eliminated some of the controversy surrounding the exempt status of hospital service organizations with the enactment of
(1) such organization is organized and operated solely -- 103 T.C. 140">*149 (A) to perform, on a centralized basis, one or more of the following services which, if performed on its own behalf by a hospital which is an organization described in subsection (c)(3) and exempt from taxation under subsection (a), would constitute activities in exercising or performing the purpose or function constituting the basis for its exemption: 1994 U.S. Tax Ct. LEXIS 53">*69 data processing, (B) to perform such services solely for two or more hospitals each of which is -- (i) an organization described in subsection (c)(3) which is exempt from taxation under subsection (a), * * * (iii) owned and operated by the United States, a State, the District of Columbia, or a possession of the United States, or a political subdivision or an agency or instrumentality of any of the foregoing;
(2) such organization is organized and operated on a cooperative basis and allocates or pays, within 8 1/2 months after the close of its taxable year, all net earnings to patrons on the basis of services performed for them; * * *
* * *
For purposes of this title, any organization which, by reason of the preceding sentence, is an organization described in subsection (c)(3) and exempt from taxation under subsection (a), shall be treated as a hospital and as an organization referred to in section 503(b)(5).
[Emphasis added.]
In sum,
Despite the enactment of
Ultimately, the issue of the exempt status of cooperative laundries made its way to the Supreme Court. Specifically, in
Putting
(1) Denial of tax exemption where providing commercial-type insurance is substantial part of activities. -- An organization described in paragraph (3) or (4) of subsection (c) shall be exempt from tax under subsection (a) only if no substantial part of its activities consists of providing commercial-type insurance.
103 T.C. 140">*151 Recently, in
The final development bearing upon the issues raised in this case concerns, as noted above, a 1988 amendment to
2. Purchasing of insurance by tax-exempt hospital service organizations
Present Law
House Bill
No provision.
Senate Amendment
The provision clarifies that the purchasing activities that may be carried on by a tax-exempt hospital service organization include the acquisition, on a group basis, of insurance (such as malpractice and general liability insurance) for its hospital members. The provision applies to purchases made before, on, or after the date of enactment.
Conference Agreement
The conference agreement follows the Senate amendment.
In sum, a tax-exempt hospital service organization may purchase insurance on a group basis for its member hospitals.
103 T.C. 140">*152 With the foregoing as background, we return to the central question of whether petitioners qualify for tax-exempt status. The parties focus on two issues: (1) Whether petitioners are engaged in "purchasing insurance on a group basis" as contemplated under
In cases requiring statutory construction, it is well established that the statute is to be construed so as to give effect to its plain and ordinary meaning unless to do so would produce absurd or futile results.
We begin with petitioners' contention that they qualify for exempt status under
Notably, no issue has been raised as to whether petitioners' activities involve "insurance" as defined by the Supreme Court, this Court, and others. See
As a result, we are left to decide whether petitioners' activities amount to "purchasing" insurance. In addressing petitioners' argument on this point, we begin with the admonition that
Exemptions as well as deductions are matters of legislative grace, and a taxpayer seeking either must show that he comes squarely within the terms of the law conferring the benefit sought. [
The implications of the disputed phrase "purchasing of insurance on a group basis" is not further developed in
Petitioners are organized and operated as separate entities under Florida law to provide a means by which their respective member hospitals can join together as a group to insure against professional liability (malpractice) and workers' compensation claims. In particular, petitioners provide centralized, cooperative insurance services to their member hospitals through the employment of actuaries, risk managers, underwriters, accountants, and other insurance consultants. Far from purchasing insurance, petitioners have assumed the role of the insurer. In the absence of specific statutory language permitting a cooperative hospital service organization to provide insurance services in this manner, we are compelled to conclude that petitioners' activities preclude them from qualifying for exempt status under
Looking past the plain language of the statute, petitioners assert that the legislative history of the provision indicates 103 T.C. 140">*154 that Congress intended the phrase "purchasing of insurance on a group1994 U.S. Tax Ct. LEXIS 53">*79 basis" to be broadly interpreted to permit cooperative hospital service organizations "to provide malpractice and general comprehensive insurance on a self-insurance basis." Petitioners further assert that Congress added the parenthetical phrase to subsection (e)(1)(A) in an effort to "override" the Commissioner's restrictive view of the provision as articulated in
As indicated, there is a paucity of legislative history on the provision. H. Conf. Rept. 100-1104 (1988),
Senate Amendment
The provision clarifies that the purchasing activities that may be carried on by a tax-exempt hospital service organization include the acquisition, on a group basis, of insurance (such as malpractice and general liability insurance) for its hospital members. The provision applies to purchases made before, on, or after the date of enactment.
Although the preceding material supports petitioners' assertion that the phrase in question was added to "clarify" the law, there is no evidence to support 1994 U.S. Tax Ct. LEXIS 53">*80 petitioners' contention that Congress intended for the provision to be liberally or broadly construed. Given that
Similarly, there is little support for petitioners' contention that Congress was attempting to express its disagreement with a particular general counsel memorandum. The legislative history does not contain a single citation of a general counsel memorandum. Moreover, petitioners' argument concerning
Contrary to petitioners' view, our interpretation of
Petitioners contend that our interpretation1994 U.S. Tax Ct. LEXIS 53">*82 of
We disagree with the proposition that our interpretation of
103 T.C. 140">*156 We likewise reject petitioners' contention that fairness and policy considerations mandate a ruling in their favor. While some might empathize with petitioners, the law simply does not provide for tax-exempt status under the circumstances presented. If a remedy is to be had at all, it must be obtained through legislative change.
2.
Respondent determined in the alternative that
In the first instance, petitioners maintain that
The Petitioners provide actuarial, accounting, underwriting, claims payment and other similar services, and hold assets to fund the program, but ultimately, it is the member hospitals of the Petitioners that provide the insurance. The Tax Commissioner has admitted * * * that the Petitioners employ an independent actuary to calculate the needed resources to meet the obligations that the member hospitals collectively have agreed to assume, plus operational expenses. If the Petitioners' expected claims and expenses exceed the resources on hand, the Petitioners assess the member hospitals. If the resources prove excessive, the excess is returned or allocated to the member hospitals. These procedures are in place because the member hospitals, not the 1994 U.S. Tax Ct. LEXIS 53">*85 Petitioners, are providing the insurance.
Contrary to petitioners' position, it is evident that petitioners are providing the insurance in question. The record in this case amply demonstrates that petitioners are established 103 T.C. 140">*157 as separate entities under Florida law to provide a means by which their respective member hospitals can join together as a group to insure against professional liability (malpractice) and workers' compensation claims. Moreover, it is petitioners, rather than their members, that provide the services essential to the administration of the insurance programs. Specifically, petitioners provide actuarial, accounting, underwriting, claims payment, and similar services. Given petitioners' integral and central role in the insurance programs, it follows that petitioners, not their members, are providing the insurance in question. Indeed, to adopt petitioners' position would be tantamount to ignoring petitioners as entities separate and distinct from their several members. This we cannot do. Cf.
Nor are we persuaded that petitioners' practice of adjusting member1994 U.S. Tax Ct. LEXIS 53">*86 premiums to reflect actual (as opposed to projected) loss experience mandates a finding that petitioners' members are providing insurance. As we see it, this aspect of the insurance programs merely assures that petitioners operate on a "break-even" basis and serves as a means for petitioners to shift the risk of insurance losses from their individual members to the whole group. It is this characteristic, petitioners' ability to shift the risk of loss, that distinguishes petitioners (the insurers) from their members (the insured).
Petitioners argue in the alternative that the insurance in question is not "commercial-type" insurance within the meaning of
103 T.C. 140">*158 Congress was concerned that tax-exempt organizations that engaged in insurance activities would enjoy an unfair advantage vis-a-vis their for-profit competitors. * * *
The problem that Code
The term "commercial-type" insurance is not defined in
Under the circumstances, we turn to the plain meaning of the words used in the statute. In employing the term "commercial-type" insurance, we understand that Congress intended for
We find explicit support for our conclusion that petitioners are providing "commercial-type" insurance as contemplated under
Present Law
* * *
The providing of insurance benefits by an organization otherwise described in
Nevertheless, at least one major organization, which provides life insurance and annuities to employees of tax-exempt educational institutions, 103 T.C. 140">*159 has been recognized as a charitable organization by the IRS. [Fn. ref. omitted.]
* * *
Reasons for Change
The committee is concerned that exempt charitable and social welfare organizations that engage in insurance activities are engaged in an activity whose nature and scope is so inherently commercial that tax-exempt status is inappropriate. The committee believes that the tax-exempt status of organizations engaged in insurance activities provides an unfair competitive advantage to these organizations. The committee further believes that the provision of insurance to the general public at a price sufficient to cover the costs of insurance generally constitutes an activity that is commercial.
In addition, the availability of tax-exempt status under present law has allowed some large insurance entities to compete directly with commercial insurance companies. * * * [Citing the rise of Blue Cross/Blue Shield1994 U.S. Tax Ct. LEXIS 53">*90 organizations.]
* * *
Explanation of Provision
Under the bill, an organization described in
In the case of such a tax-exempt organization, the activity of providing commercial-type insurance is treated as an unrelated trade or business (sec. 513) but, in lieu of the usual tax on unrelated trade or business taxable income, the unrelated trade or business activity is taxed under the rules relating to insurance companies (Subchapter L).
[Emphasis added.]
We note that H. Conf. Rept. 99-841, at II-346 (1986), 1986-3 C.B. (Vol. 4) 1, 346, generally follows the bill of the House Committee on Ways and Means with modifications that are not relevant to this discussion. Moreover, the specific concerns relating to unfair1994 U.S. Tax Ct. LEXIS 53">*91 competition articulated in the report of the House Committee on Ways and Means are echoed in the Staff of the Joint Comm. on Taxation, General Explanation of the Tax Reform Act of 1986, at 583-586 (J. Comm. Print 1987).
Although concerns relating to the activities of Blue Cross and Blue Shield organizations may have precipitated the 103 T.C. 140">*160 codification of
As we see it, petitioners' activities clearly fall within the literal and intended scope1994 U.S. Tax Ct. LEXIS 53">*92 of
In sum, we hold that petitioners do not qualify as organizations described in
To reflect the foregoing,
1. Cases of the following petitioners are consolidated herewith: Florida Hospital Excess Trust Fund B, docket No. 2967-93X, and Florida Hospital Workers' Compensation Self-Insurance Fund, docket No. 2968-93X.↩
2.
627.357. Medical malpractice self-insurance
(2) A group or association of health care providers composed by any number of members, is authorized to self-insure against claims arising out of the rendering of, or failure to render, medical care or services, or against claims for injury or death to the insured's patients arising out of the insured's activities, upon obtaining approval from the department [Fla. Dept. of Ins.] and upon complying with the following conditions:
(a) Establishment of a Medical Malpractice Risk Management Trust Fund to provide coverage against professional medical malpractice liability.
(b) Employment of professional consultants for loss prevention and claims management coordination under a risk management program.
(3) The fund may insure hospital parent corporations, hospital subsidiary corporations, and committees against claims arising out of the rendering of, or failure to render, medical care or services.
(4) The fund is subject to regulation and investigation by the department. The fund is subject to rules of the department and to part X of chapter 626, relating to trade practices and frauds.
(5) The trust fund may purchase medical malpractice insurance, specific excess insurance, and aggregate excess insurance, up to determined limits, as necessary to provide the insurance coverages authorized by this section, consistent with market availability. The trust fund may purchase such risk management services as may be required, pay claims as may arise under any deductible provisions, and engage in prudent investment of trust funds and other activities reasonably relating to the payment of claims and to providing medical malpractice self-insurance, to the extent otherwise consistent with this section and law generally applicable to medical malpractice insurers.↩
3.
440.57. Pooling liabilities
(1) The * * * [Division of Workers' Compensation of the Florida Department of Labor and Employment Security] shall adopt rules permitting two or more employers to enter into agreements to pool their liabilities under this chapter for the purpose of qualifying as a group self-insurer's fund, which shall be classified as a self-insurer, and each employer member of such approved group shall be known as a group self-insurer's fund member and shall be classified as a self-insurer as defined in this chapter. * * *↩
4.
(a) Exemption From Taxation. -- An organization described in subsection (c) * * * shall be exempt from taxation under this subtitle unless such exemption is denied under section 502 or 503.
* * *
(c) List of Exempt Organizations. -- The following organizations are referred to in subsection (a): * * * (3) Corporations, and any community chest, fund, or foundation, organized and operated exclusively for * * * charitable * * * purposes, * * * no part of the net earnings of which inures to the benefit of any private shareholder or individual, no substantial part of the activities of which is carrying on propaganda, or otherwise attempting, to influence legislation, * * * and which does not participate in, or intervene in * * * any political campaign on behalf of (or in opposition to) any candidate for public office.↩
5. Sec. 7428(a) provides in pertinent part:
SEC. 7428. DECLARATORY JUDGMENTS RELATING TO STATUS AND CLASSIFICATION OF ORGANIZATIONS UNDER
(a) Creation of Remedy. -- In a case of actual controversy involving -- (1) a determination by the Secretary -- (A) with respect to the initial qualification * * * of an organization as an organization described in * * * upon the filing of an appropriate pleading, the United States Tax Court * * * may make a declaration with respect to such initial qualification * * *.↩
2. See, e.g.,