On April 13, 2012, the Department of Health and Human Services (HHS) issued a notice outlining the fees imposed on issuers of health insurance policies and plan sponsors of certain self-insured health plans. The fees are part of the Patient Protection and Affordable Care Act (PPACA) and will help fund the Patient-Centered Outcomes Research Trust Fund’s private, non-profit Institute. The Patient-Centered Outcomes Research Institute is intended to perform research, advance evidence-based medicine, and provide insurers and consumers information for health care decision making.
Due to these imposed fees, the individual consumer and employer groups could see an increase in their premiums, beginning 2013.
Specified Health Insurance Policies
The fee applies to health insurance policies issued to individuals living in the United States. Issuers of specified health insurance policies will be required to pay a fee for each policy year. For the first year, the fee is $1. The fee increases to $2 in the second year and increases with medical information after that.
The fee also applies to plan sponsors of self-insured health plans. The plan sponsor is usually an employer, but might be another group or entity.
Medicare, Medicaid and CHIP are exempt governmental programs. Also exempt are programs established by Federal law for providing medical care (other than through insurance policies) to members/veterans of the U.S. military or their spouses and dependents; and programs established by Federal law for providing medical care (other than through insurance policies) to members of Indian tribes.
More updates will be provided as they become available.