The Wall Street Journal kind of dug this one up into the limelight as their article mentions that this was one part of the Affordable Care Act that slipped by many which I can see as compared to all the other provisions imageit’s not one that maybe stuck out but as the time gets closer it is getting a lot attention.  Money is a lot tighter too than when the law was created and thus are accounting systems looking at the analytics of all expenses.  The self insured are those companies who either run their own administration internally or contract with another company to run their medical care and claims benefits.  Many hire an insurance company anyway to administrate.

In short the charge is to help balance the budgets for monies paid for caring for the uninsured.  20 million Americans are covered by such plans and most are large employers.  Some are thinking about eliminating vision and life insurance benefits to offset the cost.  HHS has give some exemptions, but not a lot.  BD

The fee comes on top of other costs employers expect to face. Proponents of the law say it eventually will lower employers' health costs by expanding insurance coverage to 30 million Americans, meaning employers won't subsidize their unpaid medical bills.

Administrators for employee health plans have warned federal regulators they could pare insurance benefits to absorb the fee. Some benefits experts expect employers will at least partially pass on the $63 to workers.

Boeing estimates the fee will apply to about 405,000 workers and dependents it insures, costing the Chicago-based plane maker an estimated $25 million in 2014. The company spends $2.5 billion annually on health and insurance-related benefits

In 2014, insurers will be able to tap part of the $25 billion to offset medical costs from high-risk individual-market consumers that total between $60,000 and $250,000 a year. Employers and other insurance issuers will pay $63 in 2014 for every worker, spouse, child and certain retirees they cover.

Insurance companies defend the fees, saying they will indirectly benefit employers. Companies subsidize the cost of caring for the uninsured by paying higher medical and insurance prices for workers. Moving high-risk consumers into insurance policies will minimize that problem, they say.


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