Understanding the Affordable Care Act's (ACA) Fees If you are a plan sponsor offering health benefits to your employees, be aware of the upcoming costs that you will need to include in your healthcare budget.
|Health Insurance Industry Fees - will be used to offset a portion of the premium subsidies and tax credits available for individuals buying health insurance through the marketplaces in 2014. The estimated fees are for insured medical, dental and vision plans. The amount is based on the insurer's market share and will be between 2% to 2.5% of the premium for 2014, increasing in subsequent years. |
|Reinsurance Assessment Fees - payable 2014 through 2016, will be used to stabilize the premiums and help finance the cost of high-risk individuals entering the individual health marketplaces. The estimated fee for insured and self insured health plans is $63 per member per year for 2014, and decreases in 2015 and 2016. |
The actual dollar amount of these fees will vary for each plan sponsor, based on the current premium, number of plan participants and funding arrangement. For more information and the estimated cost impact to your plans, check with your insurance broker or visit the IRS website
|Comparative Effectiveness Research Fees - payable by July 31, 2013, will be used to fund research on clinical outcomes. Insurers will calculate and pay the fee for insured health plans. Plan sponsors with self insured plans must calculate and pay fees on IRS Form 720. The fee is $1 for each covered member for plan years ending before October 1, 2012 and $2 for each covered member for plan years through 2019.|