"The excise tax is based on both employer and employee premium contributions, not just what the employer pays for coverage. The definition of what's included for calculating the tax extends to tax-advantaged health care accounts such as health flexible spending accounts, health reimbursement accounts and pretax contributions to a health savings account.... Ultimately, the tax is determined by the aggregate value of the programs an employee elects, not just the medical plan value itself. Annual increases in the excise tax thresholds are not based on health care cost inflation, but instead on the Consumer Price Index, which was 1.5% for 2013 -- far less than medical cost trend and considerably less than the 4% annual health care cost increase that the better performing employer health plans are expected to achieve in 2015 after plan changes."