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H&W: Transitional Reinsurance Fee – Ordinary Business Expense

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By Compliance Dashboard
 on November 4, 2014
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The Transitional Reinsurance Program was established by Section 1341 of the Affordable Care Act. ย The intent of the program is to help stabilize premiums for coverage in the individual market during the initial years (2014 – 2016) of implementation. ย The program requires group insurance plans to make contributions that will be used to help support payments to individual market issuers that cover high-cost claimants. ย For fully-insured group health plans, the insurer is liable for the payment. ย For self-insured group health plans, the plan is liable for the contribution, but the plan may utilize a third-party administrator (“TPA”) or administrative-services-only contractor (“ASO”) to make the contribution on their behalf and the contribution will be considered a permissible expense of the plan for purposes of Title I of the Employee Retirement Security Act whether made directly or through a TPA/ASO.