United Benefit Advisors Insight and Analysis Blog

The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016. The purpose of the fee is to provide funds to help stabilize premiums in the individual insurance market in view of uncertainty about how the Patient Protection and Affordable Care Act (ACA) would affect claims experience. While insurers are responsible for reporting and paying the fee on the policies they issue, the fee will generally be passed on to the employer. Plan sponsors of self-funded plans (or their representatives) must report and pay the fee to the federal government at www.pay.gov. Below are the answers to the top five most common questions about the TRF.

Topics: ACA, PPACA, TRF, Transitional Reinsurance Fee, Danielle Capilla, ACA fees, group medical benefits

The Patient Protection and Affordable Care Act of 2010 (ACA) has many tax provisions written within its 906 pages. I’ll give a brief overview of the taxes, and sprinkle in some good news among some not-so-good news.

Topics: ACA, PPACA, Patient Centered Outcomes Research Institute, Transitional Reinsurance Fee, Jennifer Kupper, Play or Pay, Cadillac Tax, employer shared responsibility, ACA excise tax, ACA penalties, health insurers providers fee

Employers breathed a sign of relief when the looming Cadillac tax was delayed. But are you subject to other fees and penalties under the ACA? The ACA has introduced a multitude of new fees that employers must pay, in addition to penalties for non-compliance with employer shared responsibility rules. These dollar amounts change annually, as does the percentage amount used to calculate affordability in relation to the ACA. UBA’s new ACA Advisor, “Patient Protection and Affordable Care Act Fees, Penalties” gives a quick reference summary of the key 2015 and 2016 fees and penalties associated with the ACA.

Topics: ACA, Transitional Reinsurance Fee, Cadillac Tax, minimum essential coverage, Affordable Care Act, PCORI Fee, ACA penalties

The Patient Protection and Affordable Care Act (ACA) established the Transitional Reinsurance Program to help stabilize premiums in the individual private and public marketplaces. The Transitional Reinsurance Fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016, regardless of the policy or plan year. Insurers of fully insured major medical plans and sponsors of self-funded major medical plans are responsible for filing and submitting contributions for the Transitional Reinsurance Program.

Topics: ACA, TRF, Patient Centered Outcomes Research Institute, Transitional Reinsurance Fee, Jennifer Kupper, self funded health plans, Group health plans, PCORI Fee, Transitional Reinsurance Program

Recently, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services issued a Final Rule with standards for insurers and Marketplaces in 2016, covering topics such as transparency in health insurance rate increases, formulary drug lists, drug mail order opt out provisions, determination of minimum value, and benefits discrimination. Open enrollment for the 2016 benefit year will begin on November 1, 2015, and end on January 31, 2016.

Topics: PPACA, essential health benefits, PPACA Affordable Care Act, Transitional Reinsurance Fee, cost-sharing limit, transparency in health insurance rates, insurance Marketplace, benefits discrimination

The Centers for Medicare and Medicaid Services (CMS) extended the deadline for group health plans to provide their 2014 transitional reinsurance fee (TRF) submission. Filing is now due by 11:59 p.m. on December 5, 2014. The January 15, 2015, and November 15, 2015, deadlines to pay the fee remain the same. For more information on the TRF, see our recent blog. For the answers to nearly 30 questions about filing, due dates, calculation methods, payment, submission and more, CLICK HERE to Request UBA's "Frequently Asked Questions about the Transitional Reinsurance Fee (TRF)".

Topics: Centers for Medicare and Medicaid Services, TRF, Transitional Reinsurance Fee, extended, December 5, CMS

The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016. The purpose of the fee is to provide funds to help stabilize premiums in the individual insurance market in view of uncertainty about how the Patient Protection and Affordable Care Act (PPACA) would affect claims experience. Insurers are responsible for reporting and paying the fee on the policies they issue, although the fee will generally be passed on to the employer. Plan sponsors of self-funded plans (or their representatives) must report and pay the fee to the federal government at www.pay.gov.

Topics: Linda Rowings, Self-Funded, PCORI, Patient Centered Outcomes Research Institute, November 15, Transitional Reinsurance Fee