Comparative E�ectiveness Research Fee -or-Patient-Centered Outcomes Research Insitute Fee

Health Insurance Industry Fee

Transitional Reinsurance Fee

Medicare Payroll and Investment Income Tax

In year one, the fee is $1 per participant per year moving to $2 in year two and indexed thereafter, based on a per capita amount of National Health Expenditures. Health plans are allowed to pay this fee on behalf of their fully insured customers, but self-insured plans are required to remit payment directly.

Beginning in 2014, most plans will load this fee into the insured plan premiums. Health plans estimate the fee to be about 2% to 2.5% in year one, increasing to 3% to 4% in future years. Health plans are liable for the payment of this fee.

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According the HHS �nal rules, the transitional reinsurance fee is $63 per year ($5.25 per month) per participant. Self-funded emp-loyers and health plans are responsible for paying this fee.

The Medicare payroll tax applies to individuals making more than $200,000 annually or a couple making more than $250,000 annually. The payroll tax is 0.9% on employee earnings over the threshold amounts. There is no increased tax liability to employers

So, How Do You Navigate the Uncharted Health Care Reform Waters? Visit SpringGroup.com to �nd out!

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4 Not So Hidden Costs of Health Care Reform

There are several taxes and fees designed into the A�ordable Care Act (ACA) that will impact employer costs in signi�cant ways. Recent regulations on a couple of these taxes/fees provide enlightening clari�cation.

Here are a few of the more prominent ones...

Employer Consideration: Have you thought about the various ways you can count your employees to calculate this per head fee?

Employer Consideration: How will your health insurance carrier(s) handle this fee?

Employer Consideration: Do your 2014 working rates/premiums include this fee? How much will your rates increase?

Employer Consideration: Is your payroll vendor withholding the correct amount for high-income earners?