Many health insurers’ first-quarter 2014 results were hurt by that fact that their income statement now includes the annual industry fee assessed under the Affordable Care Act (ACA), according to Best. The fee begins at $8 billion in 2014 and increases gradually until reaching $14.3 billion in 2018. Beginning in 2014, health insurance issuers pay an annual fee based on net written premiums. The fee is imposed on health insurers depending on the amount of the issuer’s net written premium. The Insurer Fee applies broadly to most forms of health insurance. Many insurers have increased premiums to offset the fee. The American Action Forum estimates that the fee will result in premium increases for the average insured individual of $60 to $160 per person in 2014 and $260 for the average family. The National Association of Insurance Commissioners requires health insurers to expense the 2014 fee, which will be paid in September, in the first-quarter statutory statements rather than accruing the fee quarterly. For more information, visithttp://www3.ambest.com/bestweek/purchase.asp?record_code=227625 .