The annual Patient-Centered Outcomes Research Institute (PCORI) fee is due soon. Insurance companies and self-insured employers must submit Form 720 and payment by Monday, August 1, 2022 (July 31, 2022 falls on a Sunday).
Who must file?
The fee funds the Patient-Centered Outcomes Research Institute (PCORI) and applies to issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans. The Institute is an independent nonprofit whose focus is on clinical effectiveness research. The Affordable Care Act extended PCORI filing and fees through 2029.
Types of health coverage or arrangements that are subject to the fee:
- Accident and health coverage or major medical insurance coverage
- Retiree-only health or major medical coverage
- Health or major medical coverage under multiple policies or plans
- COBRA coverage
- Health Reimbursement Arrangements (HRA) in some situations
- Flexible Spending Arrangement (FSA) in some situations
- State & local government health or major medical plans for employees and/or retirees
Click here for a list of health coverage or arrangements that are and are not required to file and pay.
How is PCORI fee is calculated?
The fee is calculated based on covered lives, which in most cases includes employees, retirees, COBRA participants, and covered spouses and children.
- Policies and plans ending on or after October 1, 2021, but before October 1, 2022, the rate is $2.79.
- Policies and plans ending on or after October 1, 2020, but before October 1, 2021, the rate is $2.66.
How do I file and pay the PCORI fee?
Complete Part II of Form 720 for the second quarter ending June 30. Although this is a quarterly return for other types of tax, the PCORI fee is only filed once a year. Electronic payment (EFTPS) is not required for issuers and plan sponsors because quarterly PCORI deposits are not required. However, if EFTPS is used, payment should be applied to the second quarter.
If you need assistance calculating or filing your PCORI fee, or you have any other Affordable Care Act compliance needs, contact your Eide Bailly professional or a member of our Health Care Reform Team. We look forward to working with you!