The Patient Protection and Affordable Care Act (PPACA) imposes a new fee on "specified health insurance policies" and "applicable self-insured health plans" effective for plan years ending after Sept. 30, 2012. The new fee, according to IRS guidance, will be based on "the average number of lives covered under the policy or plan," IRS officials say in the notice.

Health policy issuers would pay a fee of $2 per life covered, indexed for the national health care inflation rate. According to the IRS, an insurer would use the average number of lives covered when computing the fee payment.

The fee also applies to sponsors of self-insured plans as they would also pay a fee equal to $2 multiplied by the average number of lives covered, adjusted for health care inflation.

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