{"id":818,"date":"2013-05-15T13:43:11","date_gmt":"2013-05-15T17:43:11","guid":{"rendered":"http:\/\/www.hnetalk.com\/hcr\/?p=111"},"modified":"2013-05-15T13:43:11","modified_gmt":"2013-05-15T17:43:11","slug":"facts-for-employerstransitional-reinsurance-fees-trfs","status":"publish","type":"post","link":"https:\/\/hnetalk.com\/broker\/2013\/05\/15\/facts-for-employerstransitional-reinsurance-fees-trfs\/","title":{"rendered":"Facts for EmployersTransitional Reinsurance Fees (TRFs)"},"content":{"rendered":"<p><a href=\"http:\/\/hnetalk.com\/broker\/wp-content\/uploads\/2013\/05\/Transitional-Reinsurance-Fees_TRFs.pdf\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-57 aligncenter\" alt=\"button-print-gry20\" src=\"http:\/\/hnetalk.com\/broker\/wp-content\/uploads\/2013\/04\/button-print-gry20.png\" width=\"62\" height=\"20\" \/><\/a><em>OVERVIEW: This is a temporary fee, beginning in 2014, to fund a\u00a0<\/em><em id=\"__mceDel\"><em style=\"line-height: 1.4em;\">reinsurance pool to help stabilize premiums in the individual health insurance\u00a0<\/em><\/em><em id=\"__mceDel\" style=\"line-height: 1.4em;\"><em id=\"__mceDel\"><em>market for those with pre-existing conditions. This annual fee is based on a cost per covered\u00a0<\/em><\/em><\/em><em id=\"__mceDel\" style=\"line-height: 1.4em;\"><em id=\"__mceDel\"><em>member in employer plans during calendar years 2014 through 2016. The 2014 rate is $63\u00a0<\/em><\/em><\/em><em id=\"__mceDel\" style=\"line-height: 1.4em;\"><em id=\"__mceDel\"><em>per year ($5.25 per month) per covered life. Health and Human Services (HHS) will collect and\u00a0<\/em><\/em><\/em><em id=\"__mceDel\" style=\"line-height: 1.4em;\"><em id=\"__mceDel\"><em>pay out reinsurance funds annually; 2015 and 2016 rates are yet to be determined. Details are\u00a0<\/em><\/em><\/em><em id=\"__mceDel\" style=\"line-height: 1.4em;\"><em id=\"__mceDel\"><em>provided below.<\/em><\/em><\/em><\/p>\n<p><strong>Who is subject to these fees?<\/strong><br \/>\nBoth insured and self-funded employer plans are subject to the annual fee. Although carriers<br \/>\nwill remit the fee for fully-insured plans, the cost of this fee will ultimately add to the cost of<br \/>\nemployer sponsored health plans.<\/p>\n<p><strong>May a plan sponsor contract with a Third Party Administrator (TPA) to submit the fees<\/strong><br \/>\n<strong>on their behalf?<\/strong><br \/>\nYes, unlike the Patient-Centered Outcomes Research Institute (PCORI) fees, a plan sponsor<br \/>\nmay contract with a TPA to submit the fees on its behalf.<\/p>\n<p><strong>What counting methods\u00b9 are acceptable for self-insured plans?<\/strong><\/p>\n<ul>\n<li>Actual count \u2013 the actual number of covered lives over the first three quarters of the year<\/li>\n<li>Snapshot count \u2013 representative dates in each of the first three quarters for counting covered lives<\/li>\n<li>Form 5500 method \u2013 participant counts extrapolated to capture all covered lives<\/li>\n<\/ul>\n<p><strong>Does the fee apply to each employee or are dependents counted as well?<\/strong><br \/>\nFees apply per covered life, not just to employees or subscribers\u2014covered spouses and<br \/>\ndependents, as well as covered employees, will generate fees. COBRA beneficiaries<br \/>\nare included.<\/p>\n<p><strong>Are these fees deductible\u00b2 for plan sponsors?<\/strong><br \/>\nYes, unlike the PCORI fees, plan sponsors may pay the fees from plan assets and deduct<br \/>\nthem as ordinary and necessary business expenses.<\/p>\n<p><strong>What is the timeframe for collecting and paying out the reinsurance fees?<\/strong><br \/>\nPlan sponsors and carriers are responsible for reporting their enrollment counts to HHS by<br \/>\nNovember 15 of each year (2014, 2015 &amp; 2016). HHS will provide notice of the amount due<br \/>\nwithin 30 days or by December 15, whichever is later. Payment is then due within 30 days after<br \/>\nthe date of the HHS notification.<\/p>\n<p><strong>Does the fee only apply to health coverage that is major medical coverage?<\/strong><br \/>\nYes, the fee applies to a plan that provides major medical coverage. There are several types of<br \/>\nhealth coverage which are not subject to the fee, including:<\/p>\n<ul>\n<li>Prescription drug coverage<\/li>\n<li>Health Reimbursement Accounts (HRAs) integrated with other coverage, although the other coverage, such as a high deductible health plan, may equal major medical coverage<\/li>\n<li>Health Flexible Spending Accounts (Health FSAs)<\/li>\n<li>Health Savings Accounts (HSAs)<\/li>\n<li>Employee Assistance Plans (EAPs)<\/li>\n<li>Coverage that is secondary to Medicare<\/li>\n<li>Excepted benefits, such as stand-alone vision and dental plans<\/li>\n<li>Long-Term Care Coverage (LTC)<\/li>\n<\/ul>\n<p style=\"text-align: center;\"><a href=\"http:\/\/hnetalk.com\/broker\/wp-content\/uploads\/2013\/05\/Transitional-Reinsurance-Fees_TRFs.pdf\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-57 aligncenter\" alt=\"button-print-gry20\" src=\"http:\/\/hnetalk.com\/broker\/wp-content\/uploads\/2013\/04\/button-print-gry20.png\" width=\"62\" height=\"20\" \/><\/a><\/p>\n<p>\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014\u2014<\/p>\n<p>1. Please be advised that reinsurance fee counting methods are similar to, but different from the PCORI methods available for calculating average covered lives. The reinsurance fee methods for self-insured plan sponsors are the actual count, snapshot count, snapshot factor and 5500 methods. Again, they are similar, but applied differently than the PCORI fee counting methods.<br \/>\n2. See IRS FAQ here: <a href=\"http:\/\/www.irs.gov\/uac\/Newsroom\/ACA-Section-1341-Transitional-Reinsurance-Program-FAQs\" target=\"_blank\">http:\/\/www.irs.gov\/uac\/Newsroom\/ACA-Section-1341-Transitional-Reinsurance-Program-FAQs<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>OVERVIEW: This is a temporary fee, beginning in 2014, to fund a\u00a0reinsurance pool to help stabilize premiums in the individual health insurance\u00a0market for those with pre-existing conditions. This annual fee is based on a cost per covered\u00a0member in employer plans during calendar years 2014 through 2016. The 2014 rate is $63\u00a0per year ($5.25 per month) [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":88,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[33,35,36],"tags":[],"class_list":["post-818","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-affordable-care-act","category-hcr","category-library"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/hnetalk.com\/broker\/wp-content\/uploads\/2013\/04\/HNElogo.png","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZOS-dc","_links":{"self":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/posts\/818","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/comments?post=818"}],"version-history":[{"count":0,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/posts\/818\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/media\/88"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/media?parent=818"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/categories?post=818"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/tags?post=818"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}