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PCORI Fee Reminder

Impacted plans are responsible for filing Form 720 and paying the Patient-Centered Outcomes Research Institute (PCORI) fee each year by July 31. The fee began in 2013 and ends for plan years beginning on or after October 1, 2019.

 

Who must pay the fee?

If applicable*, the PCORI fee must be paid by plans with plan years ending on after September 30, 2012, and before October 1, 2019.

 

* Stop-loss policies, stand-alone dental and/or vision plans, integrated HRAs; HSAs; FSAs, Employee Assistance Plans, disease management and wellness programs, Medicare Part C and Part D products, and employer-provided health coverage that pays secondary to Medicare, and Medicaid plans are excluded.

 

What is the amount of the fee?
The applicable fee for plan years that end between October 31, 2017 and September 30, 2018 is $2.39 times the average number of covered lives.  For policy years ending on or after October 1, 2018, the fee will increase by the projected per capita of national health expenditures.

 

The fee is subject to adjustment for projected increases in national health expenditures.
Health insurance issuers and self-funded plans must file Form 720 and pay the PCORI fee directly to the IRS. Meritain Health cannot prepare and/or file the Form 720 on your behalf; however, Meritain Health can provide you the required membership data, if requested.

 

Please contact your Client Solutions team if you have any questions, or to request membership data.


This content is being provided as an informational tool. It is believed to be accurate at the time of posting and is subject to change. It is recommended that plans consult with their own experts or counsel to review all applicable federal and state legal requirements that may apply to their group health plan. By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice.