Pension & Benefits News Self-insured plans must pay PCORI fee by July 31
Monday, July 8, 2019

Self-insured plans must pay PCORI fee by July 31

By Pension and Benefits Editorial Staff

Self-insured health plans are required by the Patient Protection and Affordable Care Act (ACA) to pay a fee to help fund the Patient-Centered Outcomes Research Institute (PCORI). The fee for the 2018 plan year is due by July 31, 2019.

Background. The ACA includes provisions that promote research to evaluate and compare health outcomes and the clinical effectiveness, risks, and benefits of medical treatments, services, procedures, drugs, and other strategies or items that treat, manage, diagnose, or prevent illness or injury. One such provision relates to the establishment of the private, nonprofit corporation, the PCORI, which will concentrate on comparative effectiveness research. To help fund the PCORI, a fee is imposed on specified health insurance policies and self-insured health plans. The fee applies for policy or plan years ending on or after Oct. 1, 2012, and before Oct. 1, 2019.

Amount of fee. The amount of the fee is based on the average number of lives covered under the plan. This July 31, self-insured plan sponsors will be responsible for paying the fee for plan years ending in 2018. If the plan ended on or after October 1, 2018 through December 31, 2018 (including calendar year plans), the fee per covered life is $2.45. If the plan years ended on or after January 1, 2018, through September 30, 2018, the fee per covered life is $2.39.

Plan sponsors should use IRS Form 720 to pay the PCORI fee.

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