Benefits Insights

If you sponsor a self-insured group health plan (or an HRA), make sure you set a calendar alert for July 31 to pay the annual PCORI fee (Patient-Centered Outcomes Research Institute fee) for the 2021 plan year. The PCORI fee and the related IRS Form 720 are due no later than July 31st. The updated form can be found here, and the PCORI fee is reported on Part II, Line 133.

As a reminder, the PCORI fee was enacted by the ACA to help fund the Patient Outcomes Research Institute and is based on the average number of covered lives under the applicable plan. Although originally set to expire after 2019, the SECURE Act extended the PCORI fee for another 10 years, meaning most plans will be responsible for the PCORI fee until 2029.

The amount due is based on the end of your plan year.  For calendar year plans, the amount due by July 31 is $2.79 per covered life.  Below is a chart supplied by the IRS showing other plan year ends and the amount due for each.

Note that the fee is due on all covered lives on the plan.  Covered lives include spouses, dependents, retirees, and COBRA beneficiaries.

If you have not been through this process before, or if you just need a quick refresher, the IRS has issued detailed guidance on the multiple methods you may use to calculate the PCORI fee, as well as instructions for completing the Form 720 and submitting your payment.

Should you have any questions about the PCORI fee or any benefits related issues, please contact any of the Graydon employee benefits team.