Skip to main navigation Skip to main content Skip to footer For Individuals & Families For Medicare For Providers For Brokers Español For Employers: For Employers Medical Savings and Spending Accounts (HRA/HSA/FSA) Wellness, Mental Health, and Behavioral Pharmacy Dental and Vision Cost Control Strategies Supplemental Health Solutions Who We Serve Overview Small Employers (51 - 499) Medium Employers (500 - 2,999) Large Employers (3,000+) Hospitals and Health Systems Higher Education K-12 Education State and Local Governments Taft-Hartley and Federal Membership and Affinity Groups Third Party Administrators Health Insurance for Expats IGO/NGOs Multinational Businesses Why Cigna Overview Industry Insights Overview Informed on Reform Workplace Wellness Consumer-Driven Health Plans Log in to Employer Portal
Home Employers Industry Insights Informed on ReformAffordable Care Act (ACA) Fees and Taxes

Fees and Taxes

Insurers and employers pay several fees and taxes to help fund the ACA.

On December 20, 2019, President Trump signed into law a full repeal - with varied effective dates - of three ACA taxes: the Cadillac Tax, the Health Insurance Industry Fee (a.k.a. the Health Insurer Tax), and the Medical Device Tax. Additionally, the agreements extended the Comparative Effectiveness Research Fee (CERF) through 2029. Read our news alert for more details.

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 now 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
  • Initial fee due July 31, 2013 was $1.00 per medical plan participant
  • The fee due July 31, 2021 will be $2.54 per participant
  • Fee is due each year on July 31 and is paid using IRS Form 720

Get additional CERF details

See payment amounts and due dates [PDF]

For more information, visit Cigna’s CERF Toolkit

Health Insurance Industry Fee

This fee on health insurers started at $8 billion in 2014 and continues to increase each year with premium growth. The fee, which applies only to insured business, is based on each insurer’s share of the taxable health insurance premium base (among all U.S. health insurers).

  • Fee applies to insured medical, dental and vision plans
  • Fee took effect in 2014 and was suspended for 2017 and 2019
  • The fee is in effect in 2020, then fully repealed and will no longer exist in and after 2021
  • Fee is built into premiums and adds 3% to 4% to costs

Learn more about the Health Insurance Industry Fee

Excise “Cadillac” tax

Originally scheduled to go into effect in 2018, the Cadillac Tax was fully repealed on December 20, 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.

Alliance to Fight the 40

Many employers, unions, insurers and health insurance industry groups worked collectively for full repeal of the 40% Cadillac Tax due to adverse effects it would have on the majority of group health plans in the country.

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 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 from 9:00 am–6:30 pm (EST), Monday through Friday
  • Email ASO_PPACA_Fees&

Learn more about the services this team provides [PDF]

Fees and taxes in detail

Comparative Effectiveness Research Fee (CERF) Details

Error loading table data.

Loading data...

Information for fully insured employers

Error loading table data.

Loading data...

Cigna reporting for fully insured employers

  • At no additional cost, Cigna 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 the Client Resource Portal (CRP) and on

Information for self-funded employers

Error loading table data.

Loading data...

Cigna reporting for self-funded employers

  • At no additional cost, Cigna 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 the Client Resource Portal (CRP) and on
  • Employers will be able to request reports for self-funded, stand-alone Behavioral Health and Cigna Global Health Benefits® plans

Health Insurance Industry Fee Details

Error loading table data.

Loading data...

View Cigna Company Names

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

Page Footer

I want to...

Get an ID card File a claim View my claims and EOBs Check coverage under my plan See prescription drug list Find an in-network doctor, dentist, or facility Find a form Find 1095-B tax form information View the Cigna Glossary Contact Cigna


Individuals and Families Medicare Employers Brokers Providers

Secure Member Sites

myCigna member portal Health Care Provider portal Cigna for Employers Client Resource Portal Cigna for Brokers

The Cigna Group Information

About The Cigna Group Company Profile Careers Newsroom Investors Suppliers The Cigna Group Third Party Administrators International Evernorth

 Cigna. All rights reserved.

Privacy Legal Product Disclosures Cigna Company Names Customer Rights Accessibility Report Fraud Sitemap


Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (“LINA”) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (“NYLGICNY”) (New York, NY), formerly known as Cigna Life Insurance Company of New York. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna.

All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.

Selecting these links will take you away from to another website, which may be a non-Cigna website. Cigna may not control the content or links of non-Cigna websites. Details