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Affordable Care Act imposes Insurer Fee on premiums. Horizon has released Brief Notes V. 22, No. 906: indicating that the Insurer Fee will increase premiums.  Many important changes in federal law will affect and are affecting your clients. The Affordable Care Act, also known as federal health care reform, imposes a fee on health insurance premiums that will increase the cost of buying health care coverage, beginning in 2014. The Insurer Fee is commonly called a premium tax. Read the entire brief notes for full details.