Reminder! PCORI Fee Due July 31
Employers who sponsored self-funded medical plans that ended sometime during 2023 are required to report and pay the ACA Patient-Centered Outcomes Research Institute (PCORI) fees no later than July 31, 2024. Fully insured plan sponsors can rely on their carriers to submit the fee on their behalf, but fully insured plan sponsors that sponsor a self-funded plan component such as a health reimbursement arrangement (HRA) or a flexible spending account (FSA) will need to file and pay for the self-funded component plan.
Payment amounts due in 2024 will differ based on the employer’s plan year. The IRS put together a chart showing applicable fee amounts depending on the plan’s year end date. The fees due in July 2024 are as follows:
- $3.00 per covered life for plan years ending after September 30, 2022, and before October 1, 2023
- $3.22 per covered life for plan years ending after September 30, 2023, and before October 1, 2024
Self-funded plans may use one of three methods to determine the average covered lives used for reporting and paying the PCORI fee: (i) the actual count method; (ii) the snapshot method; or (iii) the Form 5500 method. There are special counting rules that apply to employers offering multiple self-funded plans or a health reimbursement arrangement (HRA) integrated with a fully insured plan. For more information on these methods to determine the average number of lives covered under a policy for the policy year, please see the IRS final regulations (PDF).
The PCORI fee count and payment are submitted using the IRS Form 720.
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