PCORI Fees Due July 31

A little over a month remains until Patient-Centered Outcomes Research Institute, or PCORI, fees are due.  The Affordable Care Act requires health insurance issuers and sponsors of self-insured health plans to pay the fees which are due on July 31, 2018, for plan years ending in 2017.

Employers or plan sponsors will pay the fee on applicable self-insured plans, including Health Reimbursement Arrangements (HRA). Health insurance issuers (insurance carriers) will pay the fee on fully insured plans.  Those affected will use Form 720, Quarterly Federal Excise Tax Return, for the fees.

The PCORI fee applies to specified health insurance policies with policy years ending after Sept. 30, 2012, and before Oct.1, 2019, and applicable self-insured health plans with plan years ending after Sept. 30, 2012, and before Oct. 1, 2019.

The amount of the PCORI fee is equal to the average number of lives covered during the policy year or plan year multiplied by the applicable dollar amount for the year.

Using Part II, Number 133 of Form 720, issuers and plan sponsors will be required to report the average number of lives covered under the plan separately for specified health insurance policies and applicable self-insured health plans. That number is then multiplied by the applicable rate for that tax year, as follows:

  • $1 per year per participant for plan year ending between Oct. 1, 2012, and Sept. 30, 2013.
  • $2 per year per participant for plan year ending between Oct. 1, 2013, and Sept. 30, 2014.
  • $2.08 per year per participant for plan year ending between Oct. 1, 2014, and Sept. 30, 2015.
  • $2.17 per year per participant for plan year ending between Oct. 1, 2015, and Sept. 30, 2016.
  • $2.26 per year per participant for plan year ending between Oct. 1, 2016, and Sept. 30, 2017.
  • $2.39 per year per participant for plan year ending between Oct. 1, 2017, and Sept. 30, 2018.
  • For plan years ending between Oct. 1, 2018, and Sept. 30, 2019, the amount will be adjusted for inflation.

For additional information, visit the IRS’ Q&A on the PCORI fees by clicking here.

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