While the Patient-Centered Outcomes Research Initiative (“PCORI”) fee was updated at the turn of the year, the fee is not actually paid until July. For those of you that forgot about the fee, this is your reminder to start the process now before the good weather of summer arrives.
The Affordable Care Act imposed the PCORI fee on specified health insurance policies and plan sponsors of self-insured health. The fee is required to be reported once a year on the Form 720, Quarterly Federal Excise Tax Return and paid by its due date, July 31. The amount of the PCORI fee is based on the average number of lives covered under the policy or plan.
The PCORI fee for plan years ending on or after October 1, 2024, and before October 1, 2025, will be $3.47 per covered life. If you have a non-calendar year plan that does not fall in the above window, you may find the amount you owe here.
Payment is due by July 31 of the year following the last day of the plan year. For plan years ending in 2024, the PCORI fees are due by July 31, 2025.
Employers who sponsor self-insured plans subject to the PCORI fee are responsible for filing Form 720 and paying the fee. Self-insured health plans should speak with their TPA to determine the number of lives for payment.
Sponsors of fully insured health plans do not have to worry about the fee but if you also sponsor a health reimbursement arrangement (HRA), it is considered self-funded and the PCORI fee is due on the HRA lives.
If you have any questions about the PCORI fee, or employee benefits in general, please contact any of the Bricker Graydon employee benefits team.
