Self & Level Funded Plan Sponsors Must Submit PCORI Fee by July 31 Each Year
The Patient-Centered Outcomes Research Institute (PCORI) fee was created by the Affordable Care Act (ACA) and was effective beginning 2012.
Employers that sponsor self/level funded plans must submit the fee. Employers that sponsor insured plans need not submit because their carriers will submit instead.
The fee is submitted and paid once a year by no later than July 31 of the following year. For example, plans that ended at any time in 2021 pay the 2021 fee by July 31, 2022.
The fee is calculated by multiplying the per person fee amount by the plan’s average number of covered lives. A plan MUST calculate average number of lives using one of the following:
- Actual count method
- Snapshot count method or snapshot factor method
- Form 5500 method
The per person fee amount is adjusted each year and takes effect each October. Consequently, the amount an employer pays per covered life depends on when the plan year ends. For example, the fee due July 31, 2022 has two different fee amounts:
- Plans that ended January 2021 through September 2021 pay $2.66 per covered life.
- Plans that ended October 2021 through December 2021 pay $2.79 per covered life.
The fee is submitted using IRS Form 720, see the IRS PCORI Fee webpage.