Page 4 - SEP COPE 2014
P. 4
TAXES & FEES (01/01/2014) Small groups (under 50 FTE) will see their premium amount IN-
CREASE by the taxes and fees on their billing statement if they do not renew on 01/01/2014. All groups
renewing 01/01/2014 will see ACA Taxes & Fees as a lump sum line item on their billing statement.
TAX/FEE Description Calculation Remittance Responsibility
Method*
An annual fee that funds research on the PMPY Calculation Health Insurance issuer for
effectiveness, risks, and benefits of various .04% of premium fully-insured plans
1 Comparative Effectiveness medical treatments through the Patient- Plan sponsor for self-insured
Fee Centered Outcomes Research Institute plans
(PCORI), a nonprofit created through ACA.
2 Federal Insurance A yearly tax assessed on fully-insured pre- 2.70% of full-insured Health Insurance Issuer
Premium Tax miums. premium
A fee that will support the transitional rein- PMPM Calculation Health Insurance issuer for
surance program with the goal of stabilizing 1.29% of premium fully-insured plans
3 Reinsurance Fee premiums coverage for the individual mar- Plan sponsor for TPA for self-
ket both on and off the Marketplace. insured plans
A quarterly tax based on health insurance % based on Health Insurance issuer for
4 State Insurance Tax policies that cover individuals in the state of thresholds fully-insured plans
Michigan. 1.35% of premium Plan sponsor for TPA for self-
insured plans
Established to ensure marketplaces can be % premium Health Insurance issuers par-
self-sustaining by 01/01/2015. 0.27% of premium ticipating and offering health
5 Marketplace Fees plans on the state or federal
marketplace.
To pay for administrative expenses of run- PMPY Calculation Health Insurance issuer
6 Risk Adjustment Fee ning the federal risk adjustment program. 0.02% of premium
7 MI Claims Tax State Tax based upon claims paid ion the 0.75% of premium Health Insurer
COPE Issue VIII SEP 2014 state of MI
A Salus Group Publication © Copyright 2014 All Rights Reserved
COMING SOON
Large Group clients on our COPE program will soon have access to our new ACA
Dashboard. This dashboard will calculate ACA FTE eligibility, PT employees hours and
prepare information for the IRS 1094-C & 1095-C Reports. One more reason to en-
gage Salus Group to help you COPE with benefits compliance.
CREASE by the taxes and fees on their billing statement if they do not renew on 01/01/2014. All groups
renewing 01/01/2014 will see ACA Taxes & Fees as a lump sum line item on their billing statement.
TAX/FEE Description Calculation Remittance Responsibility
Method*
An annual fee that funds research on the PMPY Calculation Health Insurance issuer for
effectiveness, risks, and benefits of various .04% of premium fully-insured plans
1 Comparative Effectiveness medical treatments through the Patient- Plan sponsor for self-insured
Fee Centered Outcomes Research Institute plans
(PCORI), a nonprofit created through ACA.
2 Federal Insurance A yearly tax assessed on fully-insured pre- 2.70% of full-insured Health Insurance Issuer
Premium Tax miums. premium
A fee that will support the transitional rein- PMPM Calculation Health Insurance issuer for
surance program with the goal of stabilizing 1.29% of premium fully-insured plans
3 Reinsurance Fee premiums coverage for the individual mar- Plan sponsor for TPA for self-
ket both on and off the Marketplace. insured plans
A quarterly tax based on health insurance % based on Health Insurance issuer for
4 State Insurance Tax policies that cover individuals in the state of thresholds fully-insured plans
Michigan. 1.35% of premium Plan sponsor for TPA for self-
insured plans
Established to ensure marketplaces can be % premium Health Insurance issuers par-
self-sustaining by 01/01/2015. 0.27% of premium ticipating and offering health
5 Marketplace Fees plans on the state or federal
marketplace.
To pay for administrative expenses of run- PMPY Calculation Health Insurance issuer
6 Risk Adjustment Fee ning the federal risk adjustment program. 0.02% of premium
7 MI Claims Tax State Tax based upon claims paid ion the 0.75% of premium Health Insurer
COPE Issue VIII SEP 2014 state of MI
A Salus Group Publication © Copyright 2014 All Rights Reserved
COMING SOON
Large Group clients on our COPE program will soon have access to our new ACA
Dashboard. This dashboard will calculate ACA FTE eligibility, PT employees hours and
prepare information for the IRS 1094-C & 1095-C Reports. One more reason to en-
gage Salus Group to help you COPE with benefits compliance.
