2017 ACA Fees and Taxes for Fully Insured and Self-Funded Groups

Information on 2017 ACA Fees and Taxes for Optima Health

  • Patient-Centered Outcomes Research Institute (PCORI): The fee for 2017 is $2.26 per member per year, which includes the adjustment for inflation, as announced by §§ 4375 and 4376.
  • Health Insurer Fee fully insured groups only): The percentage of the premium for 2017 is dependent upon when the group renews.  The information in the chart accounts for the 2017 Moratorium and the rate is prorated based on the amount of time the group's 2017 contract extends into 2018.
2017 Renewal Month HMO PPO
January-March .00% .00%
April-June .17% .17%
July-September .33% .34%
October -December .50% .51%

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.