Individuals and employers may be responsible for other taxes and fees related to the health care reform law. The chart below highlights some of them.
| Tax/Fee | Effective Date | Responsible Party | Annual Tax/Fee Amount |
|---|---|---|---|
| Pharmaceutical Industry fee - an annual fee on branded prescription drug manufacturers and importers | Applies to any branded prescription drug sales after December 31, 2008 | Manufacturers or importers with gross receipts from branded prescription drug sales | Amount is determined by the branded prescription drug sales during the calendar year and percentage of gross receipts taken into account. |
| Medical device manufacturer tax - an annual excise tax on medical device manufacturers and importers | Applies to any medical device sales after December 21, 2008 | Manufacturers or importers with gross receipts from medical device sales | Amount paid is 2.3% of the selling price. |
| Indoor tanning service tax - a tax on any service that uses an electronic product with 1 or more ultraviolet lamps for skin tanning | Applies to services performed on or after July 1, 2010 | Individuals that use the services | Tax equal to 10% of the amount paid for a service |
| Comparative effectiveness research fee - this fee funds research on the effectiveness, risks and benefits of medical treatments through the Patient-Centered Outcomes Research Institute | Plan/policy years that end after 9/30/2012 and beginning before 10/1/2019 | Issuers of fully insured plans Self-insured plan customers |
For plan years that end during October 1, 2012 through September 30, 2013, this fee is $1 per participant per year. For plan years that end during October 1, 2013 through September 30, 2014, the fee increases to $2 per participant per year. After that, the rate increases each year by the medical inflation rate. |
| ACA Insurer fee - an annual fee to fund premium subsidies and Medicaid expansion | Tax years beginning 1/1/2014 and later | Issuers of fully insured plans |
Based on the Insurer's market share of net premiums written based on previous year. For example the 2014 fee will be based on the 2013 premiums. Total fee amount to be collected across all insurers starts at $8 billion in 2014 and increasing to $14.3 billion in 2018. After 2018 the fee increases annually based on premium growth. Starting in 2014 the fee is 2.45% of premium. |
| ACA Reinsurance fee - this will support the transitional reinsurance program that aims to stabilize premiums for coverage in the individual market and lower the effects of adverse selection | Plan/policy years beginning in the 3-year period starting in 1/1/2014 |
Issuers of fully insured plans Sponsors/administrators will collect and send the contributions on behalf of self-insured plans Exception: Employers are not subject to this fee for employees covered by both the employer coverage and Medicare, in situations when Medicare has primary claims liability. |
Funds will be used to make reinsurance payments to health insurance issuers that cover high-cost individuals in non-grandfathered individual market plans. This fee is $5.25 per participant per month. |
| High-cost Insurance tax - an annual excise tax on high-cost health plans | Tax years beginning 1/1/2018 and later | Issuers of fully insured plans Sponsors/administrators of self-insurted plans |
Tax of 40% on health plan costs that exceed "Cadillac" plan thresholds of $10,200 for single coverage or $27,500 for family coverage. |
