PCORI Fee Due by July 31, 2016
As a result of the Affordable Care Act (ACA), health plan sponsors and issuers of individual and group health insurance policies are required to pay a fee to help fund the Patient-Centered Outcomes Research Institute (PCORI). This is a private, non-profit corporation that will collect, analyze, and report on comparative clinical effectiveness research findings leading to lower healthcare costs resulting in lower premiums.
Which plans are affected?
If you offer a Health Reimbursement Arrangement (HRA), integrated with a fully insured plan or a retiree only plan, the fee will apply.
How do you determine the number of covered lives?
BeneFLEX emailed you a copy of the Average Covered Lives Report in the middle of June. If you did not receive this report, please contact us. If you offer an HRA with a fully insured health plan, you can treat each employee’s HRA as covering a single life. You do not have to include the spouse or dependents.
Who is responsible for paying the fee?
Self-funded plans including HRAs – The ACA states the employer pays the fee. The ACA does not intend to develop a process to allow third party TPAs to file and pay the fee on behalf of the self-funded employer groups. This is the ACA’s approach to funding the Patient-Centered Outcomes Research Institute.
How much is the fee?
This year, the fee will be $2.17 per covered life for plan years ending before October 1, 2016. In subsequent years, it will be indexed to national health expenditures. The fee will end in 2019.
How do you file and pay the fee?
You must file the Quarterly Federal Excise Tax Return Form 720 by July 31, 2016. To file the form, go to https://www.irs.gov/pub/irs-prior/f720–2015.pdf then go to Part II on the form, enter the number of employees covered by your HRA in Table IRS No. 133, multiply that number by $2.17 per person, and then follow IRS guidelines for submission. For additional information go to https://www.irs.gov/uac/newsroom/patient-centered-outcomes-research-institute-fee.
For questions regarding the PCORI Fee contact us at firstname.lastname@example.org or Customer Service at (314) 909-6979.