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Complicated Process - Another new health reform fee, often called the reinsurance fee, is affecting employers. Although carriers will pay the assessment on behalf of a fully-insured plan, the final cost will be passed through to employers sponsoring health plans. The third party administrators (TPA) for self-insured plans may report and pay the fee, but are not required to do so. The employer is responsible for the reporting if the TPA declines to take on this responsibility. In addition, the fee must be paid using a specific method which itself presents compliance challenges especially for some self-funded organizations.