Under the PPACA, insurance companies, including Blue Cross, will have to pay a shared fee, divided according to market share, that begins at $8 billion in 2014 and rises each year. This fee will add millions of dollars to operating costs, which Blue Cross has worked hard to keep low. In addition, in 2013, an annual fee becomes effective on insured and self-insured plans to fund the patient-centered outcomes research trust fund (also research trust fund (also created by the law).
Beginning in 2014, the new law limits the ability of insurance companies to charge higher rates due to health status, gender or other factors. Premiums can vary based only on age (no more than 3:1), geography, family size and tobacco use.
The new law limits the deductibility of executive compensation under Section 162(m) for certain insurance companies.
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