An easily overlooked PPACA fee has just gone mainstream and now many employers are scrambling to clean up their benefits membership pools. It’s no secret that Health Care Reform is packed with administrative rules and regulations that impact Dependent Eligibility, but PPACA requires that either the employer or the medical carrier must pay a “Reinsurance Fee” of $63 per MEMBER covered in a major medical plan.
The impact is that for every employee and every dependent he/she covers for medical, the employer is paying a $63 fee. The $63 fee is passed on to the group through premium increases, but for Self-Funded plans the business must pay the $63 directly. For a life group with the average 2.2 dependents covered, the added Reinsurance Fee is nearly $14,000. For a 500 life group the average resulting fee would be roughly $70,000. These new mandatory membership fees are incenting businesses to take a close look at verifying their medical member pool, whether through comprehensive dependent audits or ongoing maintenance verification with a partner.