The Affordable Care Act (ACA, health care reform law) affects health care benefits and costs for businesses and employees. Among the ACA provisions are federally required fees and taxes, including: Comparative effectiveness research fee, ACA reinsurance fee and ACA insurer fee. Anthem will pay the comparative effectiveness fee for fully-insured customers however the reinsurance and insurer fees will bee included in the monthly bill for Anthem clients. These fees will apply to all insurers, regardless of health plan carrier.