Fees Associates with the Affordable Care Act to be Imposed on Most Healthcare Plans

The Affordable Care Act (ACA) established a new non-profit organization called the Patient-Centered Outcomes Research Institute (PCORI) to:

  • Conduct research which would evaluate and compare health outcomes; and,
  •  Conduct research into the clinical effectiveness, risks and benefits of medical treatments

The PCORI will be paid for via a trust funded by the payment of fees by insurers, employers, and other funding from the federal government.

The IRS just recently released their proposed regulations for comment and to address questions raised by employers and others about the fees imposed.

The ACA-mandated fee is $1 per plan participant (based on average number of covered employees and dependents) for the first plan year ending after September 30, 2012, and $2 per plan participant in succeeding years.  For plan years starting after September 30, 2014, the fee is to be indexed to reflect the percentage increase in national medical expenditures (as per the Department of Health and Human Services).  The fees do not apply to plan years ending after September 30, 2019.

Note that these are proposed regulations and may change before final adoption.