Health care reform requires health insurance issuers and self-insured group health plans to pay a transitional reinsurance fee in 2014, 2015 and 2016. For 2015, the fee will be $44 per covered life. Insurers will pay the fee for fully-insured plans, but plan sponsors will have to pay the fee for self-funded plans.
The fee is due on major medical plans. It does not have to be paid on stand-alone dental or vision plans, retiree medical plans that pay secondary to Medicare, health reimbursement arrangements, health savings accounts or flexible spending accounts.
For 2015, entities must submit their enrollment count through https://pay.gov/public/home using the “2015 ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form.” The count must be provided no later than Monday, November 16, 2015. The website will calculate the amount owed based on identified enrollees.
The number of covered lives on which the fee is due can be calculated using one of the following methods:
Employers with self-funded plans should prepare for the transitional reinsurance fee, which could be costly for those with high plan participation.