A case currently on appeal to the Supreme Court could affect the tax-exempt status of thousands of nonprofit health maintenance organizations.Vision Service Plan, the largest not-for-profit vision benefits and services company, was initially granted a tax exemption in 1960 as a social welfare organization under Section 501(c)(4).

The roots of the case began in 2003, when the Internal Revenue Service revoked the tax-exempt status for VSP's California corporation, whereupon VSP California filed and subsequently paid income taxes for 2003 and then filed in federal district court for a refund.

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