Obamacare Federally Mandated Additional Fees on your Premium

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Sue J

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I searched to see if this was already discussed and didn't find anything.

We got a letter today from our health care insurer for 2014. We are enrolled for a bronze plan with an HSA and already paid for our January premium.

The letter is to let us know about the healthcare reform related things we should know about, like prenatal care, Essential Health Benefits, no exclusions for pre-existing conditions, max out of pocket costs, etc. I was aware of all of these.

Then this -

Additional federally mandated fees will begin to appear on your invoice in 2014. You will see the following fees on your invoices:

- Patient-Centered Outcomes Research Institute (PCORI) at $0.18 per member per month. This fee is scheduled to end in 2019.
- Transitional Reinsurance Program Fee at $5.25 per member per month in 2014. This fee is intended to decrease through 2016, when the fee ends.
- Market Share Fee at 2.4 percent of your total premium.
- Risk Adjustment fee at $0.08 per member per month. This fee will not appear on your invoice until after your renewal.

The example also shows a State Premium Tax of 1.4%. I don't know if this applies to our state but it's pretty likely.

I'M NOT COMPLAINING!

We are happy to be able to buy a high deductible plan with an HSA and get a nice subsidy compared with our other choice of DH's retiree health insurance that was $400/mo more and far more coverage then we need. I'm just surprised. This will cost us an additional $31/mo which is still very affordable compared to the alternatives.

I read all the Obamacare topics here and don't remember reading about federally mandated additional fees.

Reminds me of the landline phone companies and all the extra fees that would show up.
 
My husband got notice of such Federally mandated fees on his old insurance.

But I assumed the new quotes effective 1/1/14 already included these fees.
 
And remember the promises of when many of those landline taxes/fees were scheduled to end? Such fees are now >25% of my total phone bill :(
 
audreyh1 said:
My husband got notice of such Federally mandated fees on his old insurance.

But I assumed the new quotes effective 1/1/14 already included these fees.
Click to expand...

Our 2013 retiree insurance is from the same insurance company as our new 2014 Obamacare insurance. Now I'm curious as to which one this pertains to. I assumed it was for the 2014 premium since it gives examples of a monthly premium bill showing the fees added on. With the retiree insurance for 2013 we never saw a bill, it was withheld from the pension deposit.

We've canceled the retiree insurance effective 1/1/2014 and already enrolled in, and paid for the first month of the subsidized plan for 2014.
 
Sue J said:
Additional federally mandated fees will begin to appear on your invoice in 2014. You will see the following fees on your invoices:

- Patient-Centered Outcomes Research Institute (PCORI) at $0.18 per member per month. This fee is scheduled to end in 2019.
- Transitional Reinsurance Program Fee at $5.25 per member per month in 2014. This fee is intended to decrease through 2016, when the fee ends.
- Market Share Fee at 2.4 percent of your total premium.
- Risk Adjustment fee at $0.08 per member per month. This fee will not appear on your invoice until after your renewal.

The example also shows a State Premium Tax of 1.4%. I don't know if this applies to our state but it's pretty likely.
Click to expand...

Does anyone know if these are new fees beginning with PPACA? Or are these (or something similar) already included in individual insurance premiums? Maybe PPACA is listing these separately in an attempt to be transparent. I suspect not.

If these are new fees my guess is they're some of the many fees interwoven in PPACA in an attempt to make the implementation of the law to be "revenue neutral."
 
rbmrtn said:
Something doesn't sound right. The transitional reinsurance is on employer and self insured group plans, and for them is tax deductible

Transitional Reinsurance Fee

PCORI & Reinsurance Fees

I'm sure your insurance would never pass up chance to "stick" to you.
Click to expand...

Hmmm. Our 2013 retiree plan is a self insured group plan operated by the pension system. The letter doesn't identify a group number or policy name so I can't tell if it's for our old plan or our new plan. Curious.

I'll have to call and ask some questions on Monday.
 
rbmrtn said:
Something doesn't sound right. The transitional reinsurance is on employer and self insured group plans, and for them is tax deductible

Transitional Reinsurance Fee

PCORI & Reinsurance Fees

I'm sure your insurance would never pass up chance to "stick" to you.
Click to expand...

Thanks for the links. I know more now (but still a little confused) about the fees. I does appear that implementation of PPACA requires these fees in order to be revenue neutral. With that in mind the insurance company is simply following the law - collecting the fees and paying them to the appropriate government agency. In my mind that means the government is sticking it to you - not the insurance company.
 
my old policy was renewed for another year. it is an hsa, but curiously the premium only went up 28 dollars. do you think that was the fees? the letter didn't say anything about fees, just that our 2014 premium would increase 28.
 
Are these fees already built into the new quote I received for next year's insurance, or are they on top of them?
 
Here' a few more links to some info.

http://www.gpo.gov/fdsys/pkg/FR-2012-03-23/pdf/2012-6594.pdf ( see table in section B INTRODUCTION, who participates )

https://sites.google.com/site/healthreformnavigator/ppaca-sec-1342 ( see b(1)(A) )

(A) health insurance issuers, and third party administrators on behalf of group health plans, are required to make payments to an applicable reinsurance entity for any plan year beginning in the 3-year period beginning January 1, 2014 (as specified in paragraph (3)


The way I read it was that group plans ( employer, self-insured ) were to pay in, The individual plans could get reimbursed based on covering HIGH RISK individuals... who knows, clear as mud!
 
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I have my husband's BCBS TX notice from Oct 20 in front of me:

The monthly premium increase is $21 for "two new Affordable Care Act fees" starting Jan1.
These fees are the "Annual Fee on Health Insurers" and the "Transitional Reinsurance Contribution Fee".
Click to expand...

A footnote mentions the Reinsurance Fee lasts through 2016.

So clearly these fees apply to individual policies.
 
Really folks, who cares. The fees are modest and the ACA will help a lot of retirees.
 
Theduckguru said:
Really folks, who cares. The fees are modest and the ACA will help a lot of retirees.
Click to expand...

Fees and taxes have a way of creeping up and piling on over time. In addition, these fees appear through the back door under the guise of making PPACA revenue neutral. IMHO PPACA will never be revenue neutral - maybe on some government accounting sheet - but the government simply added fees and taxes on a variety of goods and services (some not even related to health care) in an attempt to pay for this law. For people with unsubsidized premiums PPACA insurance costs more than conventional individual insurance. And for those who receive subsidies don't forget that's somebody else's money paying for your premium.
 
Actually, these fees are an effort to help pay the cost of setting up and operating the exchanges, and seem pretty "upfront" to me. Risk management for the benefit of the insurers is also included here. They certainly aren't hidden. ACA tax credits and cost sharing subsidies are paid for from general tax revenue.
 
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I had a long phone conversation with our insurer and here's what I learned.

The letter pertains to our insurance for 2014, the subsidized Marketplace policy. But, the fees are already included in our quote.

This was verified by talking to a Marketplace adviser at our insurance company who generated a new quote from our zip code and ages and the plan we've enrolled in and it was the same as I had gotten from HealthCare.gov which was then reduced by our subsidy. He said that his system quotes the premium with the federal fees included.

Nice to know. They really should have explained this better as the letter says that these fees will be added to your invoice and an example shows the fees as an additional item.
 
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nvestysly said:
For people with unsubsidized premiums PPACA insurance costs more than conventional individual insurance. And for those who receive subsidies don't forget that's somebody else's money paying for your premium.
Click to expand...

Definitely not true. We're saving a considerable amount over COBRA and even more vs. what we would be paying on the private market based on 2013 ehealthinsurance.com rates. We've had some minor aging joint issues the last two years and we each have a history of prescription drug use, so I'm not even sure we could get coverage privately. We are far from qualifying for a subsidy. :dance: I've seen people turned down for some really stupid stuff.
 
AllDone said:
Definitely not true. We're saving a considerable amount over COBRA and even more vs. what we would be paying on the private market based on 2013 ehealthinsurance.com rates. We've had some minor aging joint issues the last two years and we each have a history of prescription drug use, so I'm not even sure we could get coverage privately. We are far from qualifying for a subsidy. :dance: I've seen people turned down for some really stupid stuff.
Click to expand...

Definitely depends on the individual and their circumstance as mine will more than triple once my underwritten plan expires next year.
 
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