Essentially insurance plans that are a result of collective bargaining would be exempt through 2018. It is important to note, this is a tax on insurance companies that market and sell high-cost plans. The tax will hit only 3 percent of the premiums of the plans that they sell, and they can avoid it by selling a more affordable health care plans.
The threshold at which the tax on so-called “Cadillac plans” has been adjusted as a result of this deal — increasing from $23,000 a year for a family policy, to $24,000.
The threshold is even higher for certain plans with older workers and women, a move to benefit unions with a high proportion of female membership.
The agreement on the high-premium excise tax would:
- Include permanent  adjustments based on age, gender and high-risk professions – factors that affect  the cost of health plans regardless of the generosity of the benefits they  provide.   This makes good sense, as it focuses the impact on plans that provide  the highest-cost benefits – not those that happen to cover the highest-cost  workers.
 
- Exempts the cost of  dental and vision plans from the cost of coverage.  These benefits are outside  the core health spending which this provision is aimed at  slowing.
 
- Provide transition  relief to help employers, insurers and workers adjust to the permanent  provision. This includes a transition period for high-cost states, as well as  providing health plans for state and local workers and collectively bargained  plans a 5-year transition window before being subject to the tax. This is  similar to the approach in other areas of the bill – including insurance market  reforms and the insurer fee – where transition periods are built in to give  stakeholders time to adjust.
 
