Transitional reinsurance fee: This fee will be imposed on employersfor the next three years and will go towards helping the state-based insurance exchanges, where individuals can find coverage, pay for large claims. The fee will be $63 per insured member in 2014, but is expected to decrease in the latter two years. Delta said this fee will cost it more than $10 million next year.
Patient Centered Outcomes Research Institute fee: This charge will go to pay for a new agency tasked with giving patients a better understanding of the prevention, treatment and care options available, and the science that supports those options. Employers will be charged $1 per insured person this year, $2 in 2014 and then increases with inflation in health care spending for the next five years.
Health insurer fee: This annual fee is aimed at helping pay for the implementation of ACA. It will be about 2.5% of total premiums in 2014 and is expected to go up to 4% by 2017. Beyond that, it will rise with the growth in premiums. Insurers are expected to pass this fee through to employers.
'Cadillac' tax: Starting in 2018, employers who offer rich benefit plans -- where the total premium will cost more than $10,200 for an individual plan or $27,500 for family coverage -- will have to pay the so-called Cadillac tax, a 40% tax on the amount over the threshold. This tax is prompting companies to shift more medical expenses onto employees, which not only brings down the price of the premiums, but also pushes employees and their spouses to consider other options available to them, said Sandy Ageloff, senior consultant with Towers Watson, a professional services firm.
Individual mandate: Also adding to employer costs is the Obamacare requirement that Americans obtain insurance or face a penalty starting in 2014. That will prompt many employees who had opted out of their company's coverage to sign up. Delta, for instance, estimates this will add $14 million to its costs annually.