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 in 2025, PCORI Fees are due by July 31, 2026.
PCORI Fees are based on when a Plan Year ends and the number of covered lives.
|
Plan Year Ending Dates |
Fee Per Covered Life |
|
For plan years ending in Oct through Dec of 2025 |
$3.84 |
| For plan years ending in Jan through Sept of 2025 |
$3.47 |
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.
Form 720
Form 720 Instructions
If you have questions or need additional help please let me know. We have several solutions to help your clients ensure timely filing of this fee.