ACA Employer Fees

So now we are well into 2014 and several fees are showing up. What are they all for and how long will we be paying them? There are four new fees. Here’s the scoop.



Health Insurance Industry Fee also known as the Health Insurance Tax (HIT)

This fee is to help off-set the cost-generating provisions of the PPACA. It is an annual fee which will be from 1.9% to 2.3% in 2014 and increasing to 2.8% to 3.7% by 2023. Self-insured plans do not pay this fee. It is for fully-insured plans only.


Reinsurance Assessment Fee

This fee is to fund a three-year reinsurance program designed to reimburse companies that insure high-cost patients through the individual health insurance market. This fee is $5.25 per covered person per month. That means each employee and their dependents will be assessed the $5.25 each. This fee is subject to change in 2015 and 2016. Self-insured and fully-insured plans are charged.


Patient-Centered Outcomes Research Institute Fee (PCORI)

This fee is to fund research by the PCORI that will compare different medical treatments and interventions to determine what treatments are most effective. The non-profit institute was established by the PPACA. The fee is $1 annually per average number of covered lives for plan years ending between October 1, 2012 and September 30, 2013. The fee increases to $2 per average number of covered lives for plan years ending between October 1, 2013 and September 30, 2014. Thereafter the fee is based on increases in the projected per capita amount of the National Health Expenditures. This fee will not apply to policies that begin after September 30, 2019. This fee applies to self-insured and fully-insured plans.





Federally Facilitated Exchange User Fee – NOT APPLICABLE TO WASHINGTON

This fee is used to pay for access to exchanges facilitated by the federal government. The fee is 3.5% of the premium. If your state has its own exchange, this fee does not apply.