Pension & Benefits News Adjusted applicable dollar amount for fee imposed on health insurance plans announced
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Monday, November 12, 2018

Adjusted applicable dollar amount for fee imposed on health insurance plans announced

By Pension and Benefits Editorial Staff

The IRS has announced that the applicable dollar amount used to calculate the fees imposed by Code Secs. 4375 and 4376 for policy and plan years that end on or after October 1, 2018, and before October 1, 2019, is $2.45. This figure is based on the percentage increase in the projected per capita amount of the National Health Expenditures published by HHS on February 14, 2018.

The fees, used to fund the Patient-Centered Outcomes Research Trust Fund (PCORTF), are generally calculated by multiplying the average number of lives covered under the health insurance policy or self-insured health plan by the adjusted applicable dollar amount. The adjusted applicable dollar amount is the sum of (1) the applicable dollar amount for the policy year ending in the previous federal fiscal year, plus (2) that amount multiplied by the percentage increase in the projected per capita amount of the National Health Expenditures most recently released by HHS before the beginning of the federal fiscal year (see Reg. §46.4375-1(c)(4) and Reg. §46.4376-1(c)(3)).

SOURCE: Notice 2018-85, I.R.B. 2018-48, November 26, 2018.

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