The Patient-Centered Outcomes Research Institute (PCORI) fee deadline is around the corner. In Notice 2022-59, the IRS adjusted the applicable dollar amount to be multiplied by the average number of covered lives for purposes of calculating the fee for policy years and plan years that end on or after October 1, 2022, and before October 1, 2023. The fee for the forgoing period is $3.00. Although the PCORI fee is based on the plan year, the reporting and fee due date is always July 31. The Affordable Care Act (ACA) requires health insurers and sponsors of self-funded group health plans and HRAs to pay the fee using IRS Form 720.
The PCORI fee is based on covered lives. Accordingly, both employees and retirees and their covered spouses and children generally must be counted. The PCORI fee is based on a plan year, with the count determined based on the entire plan year.
The PCORI fee is small and was initially in effect from 2012 through 2019. However, in December 2019, the Further Consolidated Appropriations Act, 2020 extended the fee to plan/policy years ending before October 1, 2029. It is designed to fund research into the most effective ways of treating various diseases. The IRS has not announced the fee for subsequent plan years beyond 2023.
Innovative’s account team is actively working on these calculations for our clients and will be in touch shortly. If you have any questions, please contact Innovative Benefit Planning at icomply@ibpllc.com.
