Fees and Taxes

Fees and taxes overview

Comparative Effectiveness Research Fee (CERF)

The ACA established the Patient-Centered Outcomes Research Institute (PCORI) to fund and conduct research to compare the effectiveness of various medical services used to treat, manage, diagnose or prevent illness or injury. Originally effective Oct. 2011 - 2019 (with final payments due in 2020), the Comparative Effectiveness Research Fee (CERF) is currently extended through 2029 (with final payments due in 2030). The work of PCORI is partially funded by this fee.

• Annual fee applies to insured and self-funded medical plans from 2011 through 2029, with final payments due 2030
• Fee for any given plan year is due July 31 that follows the last day of the plan year and is paid using IRS Form 720
• Annual payment amounts are available on the IRS FAQs page under Question 3

Get additional CERF details

Health Insurance Industry Fee

This fee on health insurers started at $8 billion in 2014 and increased each year with premium growth. While the fee took effect in 2014, it was suspended for 2017 and 2019, then fully repealed effective in 2021. The fee, which applied only to insured business, was based on each insurer’s share of the taxable health insurance premium base (among all U.S. health insurers).

Excise “Cadillac” tax

Originally scheduled to go into effect in 2018, the Cadillac Tax was fully repealed in 2019. It no longer exists and will never take effect. Its goal was to reduce health care usage and costs by encouraging employers to offer plans that were cost-effective and engage employees in sharing in the cost of care. The tax applied to both insured and self-funded group health plans.

Reinsurance Fee

This annual fee on medical plans was collected from 2014 through 2016, and sunset after the final payments were made in 2017. The majority of the $25 billion collected was used to fund a reinsurance program intended to lessen the impact of adverse selection in the individual market. The fee applied to both insured and self-funded medical plans, and was paid by the plan insurer.

For questions about fees and taxes

The Cigna Healthcare^SM ASO PPACA Fees and Reporting Resources team is available to respond to questions from sales, brokers and clients.

This team can be reached by phone and email:

• Call 855.275.0555, from 9:00 am–6:30 pm (EST), Monday through Friday
• Email ASO_PPACA_Fees&Reporting@Cigna.com

Comparative Effectiveness Research Fee (CERF) Details

Information for fully insured employers

Cigna Healthcare reporting for fully insured employers

• At no additional cost, Cigna Healthcare will provide information on HRA/FSA covered lives via self-service reporting, based on eligibility as of the 15th of each month
• Employers will have the option of using this data or their own data for calculating the fee payable for HRAs/FSAs
• Eligibility information is available on Cigna for Employers

Information for self-funded employers

Cigna Healthcare reporting for self-funded employers

• At no additional cost, Cigna Healthcare will provide information on covered lives via self-service reporting, based on eligibility data as of the 15th of each month
• Employers will be able to access a report for: Medical, Pharmacy, Behavioral, FSAs, HRAs and Medicare Surround and Medicare Expand
• Available on Cigna for Employers
• Employers will be able to request reports for self-funded, stand-alone Behavioral Health and Cigna Global Health Benefits^® plans

View Cigna Healthcare Company Names

*Some benefits may be covered under an insured plan and therefore subject to this fee.