Little-known health reform rule could add surprise costs to you
Tucked-away in the health reform law is a small rule that could cause employers significant headaches. And it’s set to take effect soon.
The health reform law imposes a fee on health insurance issuers and plan sponsors of self-funded plans to help fund the Patient-Centered Outcomes Research Institute (PCORI).
On the surface, it appears like insurance companies and self-funded plans are the only ones that will have to deal with this new fee.
However, the DOL is said to be “considering permissible funding sources” for the fees. That means there’s a good chance insurers could pass the fee cost right to businesses – and plan participants.
Plans/policies ending between Oct. 1, 2012 and Oct. 1, 2013 are scheduled to be the first group hit with the PCORI fee.
The initial fee will be $1 multiplied by the average number of “covered lives” (employees, former employees in the plan, spouses, dependents and other beneficiaries under the plan/policy during the year). For plan/policy years ending on or after Oct. 1, 2013, the fee jumps to $2 times the average covered lives.
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