Four new Fees-PPACA (Taxes ?)

The Patient Protection and Affordable Care Act (PPACA) introduced new fees for health insurance companies and plan sponsors, which are typically employers. Below are some highlights on the four new fees:  The Health Insurance Fee, Reinsurance Assessment Fee, Patient-Centered Outcomes Research Institute Fee, and the Federally Facilitated Exchange User Fee.

1. The Health Insurance Industry Fee-This is to help off-set the cost generating provisions of the PPACA.  It is an annual fee effective in 2014, and is due no later than September 30th annually. The Insurance Companies are responsible to pay this fee, but customer rates will be impacted. This applies to Fully insured plans only.  This fee is estimated to increase premiums in the fully insured marekt on average by 1.9% to 2.3% in 2014 and, by 2023 to increase premiums 2.8% to 3.7%.
2. Reinsurance Assessment Fee-This is to fund a three-year reinsurance program designed to reimburse companies that insure high-cost patients through the individual health insurance market.  It is an annual fee assessed from 2014 to 2016, which is due within 30 days after the date of the HHS notification of contribution due.  This fee applies to both fully insured and self funded plans.  Beginning in 2014, the fee is $5.25 per covered person per month, or $63 per year.  This amount is subject to change thereafter. With fully insured plans Insurance Companies pay but customer rates will be impacted. With Self-Insured plans the Plan Sponsor (typically the employer) will be responsible for payment.
3. Patient-Centered Outcomes Research Institute Fee-This is to fund research by the Patient-Centered Outcomes Research Institute (PCORI) that will compare different medical treatments and interventions to determine what treatments are most effective.  This non-profit institute was established by the PPACA.  This is an annual fee assessed from 2013 to 2019, which must be reported on IRS Form 720 by July 31, 2013.  This fee applies to both fully insured and self insured group plans.  The fee is $1.00 per covered person for plan years ending on or after Oct 1, 2012, through September 30, 2013.  $2.00 per covered person for plan years ending on or after October 1, 2013 through Sept 30, 2014.  Rates in subsequent years are tied to increases in the per capita amount of the National Health Expenditures.  Fees will not apply to plans with coverage periods that begin after September 30, 2019.  On fully insured plans, the Insurance Company pays this fee, but the customer rates will be impacted.  With Self-Insured plans the Plan Sponsor (typically the employer) will be responsible to pay the fee.
4. Federally Facilitated Exchange User Fee-The purpose of this fee is to pay for access to exchanges facilitated by the Federal Government.  It is a monthly fee which is effective in 2014.  The actual due date of this fee is yet Unknown.  The insurance Companies offering health insurance products through exchanges facilitated by the Federal Government will be responsible for paying this.  This fee applies to Fully insured plans only.  The amount of this fee is the monthly user fee based on a percent of premium attributed to an insurer's exchange-based sales. For 2014, the percent of premium proposed is 3.5%