Email Sent: 6/12/19
Below is a summary of PCORI fee requirements so you can advise your clients about this upcoming compliance deadline.
What is the PCORI Fee?
- The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute to study clinical effectiveness and health outcomes. To finance the nonprofit institute’s work, a small annual fee is charged on health plans.
Who pays PCORI Fees?
- Employers that self-insure a Health Plan or an HRA, and commercial group health insurance providers are responsible for paying the fee.
- It is important to note for self-funded, level funded and standalone HRA plans, the carrier will NOT remit this fee for your clients nor will your clients be invoiced. Third-Party Administrators are prohibited under the health reform law from remitting the fee for employers. As such, we have outlined the Fee Schedule and remittance information so you can advise your clients how to calculate, report, and pay this fee.
When are PCORI fees due and how are they calculated?
- For Plan Years that ended on or after January 1, 2018 through December 31, 2018,
PCORI Fees are due by July 31, 2019.
- PCORI Fees are based on when a Plan Year ends and the number of covered lives.
| Plan Years Ending | Fee Per Covered Life |
| From 1/1/2018 through 9/30/2018 | $2.39 |
| From 10/1/2018 through 12/31/2018 | $2.45 |
How do employers report and pay the fee?
The fee is reported with IRS Form 720. Below are links to the form and instructions from the IRS.