2018 ACA Fees and Taxes for Fully Insured and Self-Funded Groups

The Internal Revenue Service has announced the rate for the 2018 annual taxes and fees insurers and self-funded groups are required to pay under the Affordable Care Act (ACA).

  • Patient-Centered Outcomes Research Institute (PCORI): The fee for 2018 is $2.39 per member per year. The rate includes the adjustment for inflation, as announced by §§ 4375 and 4376.
  • Health Insurer Fee (fully insured groups only): The percentage of premium for 2018 is 1.1% for HMO and 3.4% for PPO.

The Transitional Reinsurance Contribution ended in 2016.

Fully insured groups: The group rate includes all applicable fees and taxes.

Self-funded groups: The PCORI fee must be paid directly to the Internal Revenue Service, using Form 720. Customers with questions about the filing of this form should consult with their tax advisor or accountant.

Download a chart outlining the specific provisions and correlating fees/taxes.

Please contact your Optima Health representative if you have any questions.