2023 PCORI Fee Released


If you sponsor a self-funded health plan, you or your administrator are required to file Tax Form 720 (available at ) and make any payment due directly to the IRS. If you offer fully insured plans, your insurer will complete the filing but may bill you the annual fee. Health insurance carriers pay the fee on behalf of fully-insured plans, but employers are responsible for reporting and paying the fee for any self-funded group health plans, including HRAs.

For example, PCORI fees for calendar year 2021 plans are due on July 31, 2022. Plan sponsors who must pay the PCORI fee but are not otherwise required to report any other liabilities on Form 720 are only required file Form 720 only once a year . No other filing is required in the first, third or fourth quarters of the year. Deposits are not required for PCORI fees, so plan sponsors are not required to pay the fee using EFTPS.

Health Plans Must Submit Gag Clause Attestations by December 31, 2023

Emerald Law — Emerald is a Senior Compliance Consultant for Sequoia, where she works with our clients to optimize and streamline benefits compliance. In her free time, Emerald enjoys stand-up comedy, live music, and writing non-fiction. Diane Cross — Diane is a Client Compliance Consultant for Sequoia, where she works with our clients to optimize and streamline benefits compliance.


As a reminder, the PCORI was established as part of the Affordable Care Act to conduct research to evaluate the effectiveness of medical treatments, procedures and strategies that treat, manage, diagnose, or prevent illness or injury. Under the ACA, most employer sponsors and insurers were required to pay PCORI fees until 2019 or 2020, as it only applied to plan years ending on or before September 30, 2019. However, the PCORI fee was extended to plan years ending on or before September 30, 2029 as part of the Further Consolidated Appropriations Act, 2020.

Patient-Centered Outcomes Research Institute fees due July 31

NLR does not answer legal questions nor will we refer you to an attorney or other professional if you request such information from us. This alert was prepared for Woodruff Sawyer by Marathas Barrow Weatherhead Lent LLP, a national law firm with recognized experts on ERISA-governed and non-ERISA-governed retirement and welfare plans, executive compensation, and employment law. Employers that only sponsored fully insured plans in 2021 have no action item .

  • It is general in nature and should not be considered financial, legal or tax advice.
  • Please note that Winston requires that all attendees at events hosted or sponsored by Winston & Strawn need to be fully vaccinated against COVID-19 and to comply with local health and safety guidelines.
  • Employer with a self-insured medical plan has short plan year from July 1, 2021 through December 31, 2021 to transition to a calendar plan year as of 2022.
  • You may enter the number of lives on both lines if you are filing for a full 12-month plan year and a short plan year.
  • There is no exception from the PCORI fee for an HRA offered along with fully insured major medical coverage.

However, the Further Consolidated Appropriations Act, 2020 , extended the PCORI fee for 10 years. As extended, the PCORI fee will continue to be imposed through plan years that end before October 1, 2029. By cultivating a diverse, equitable and inclusive culture, we seek to reflect those we serve and engage the perspectives, ideas and innovative thoughts that inspire outstanding legal solutions and exceptional service.

New PCORI Fee Rates Released

If you are looking for more specific details on how to calculate https://adprun.net/, please feel free to refer to the IRS’ calculation methodologieshereor contact your AssuredPartners Account Manager for assistance. The content of this article is intended to provide a general guide to the subject matter. For more information on paying the PCORI fee, see our prior posts here and here, and the IRS website here. Vita Planning Group LLC understands and attests that they are an ERISA fiduciary as defined in the Fiduciary Rule under the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code of 1986.


The PCORI fee was set to expire in 2019 but was extended for an additional 10 years and will now expire the plan year ending after September 30, 2029. Insurance carriers will calculate and pay the fees on behalf of fully insured plans, but carriers typically pass those fees through to the plan. Self-funded plans, including health reimbursement arrangements , must calculate the fee. Self-funded plans may engage a third-party administrator to assist with PCORI fee calculation, but the plan sponsor ultimately bears the burden of filing IRS Form 720 and paying the applicable fee. However, PCORI fees are reported and paid annually, and fees are “dropped into” the second quarter’s filing of Form 720. Payment is due no later than July 31 of the calendar year immediately following the last day of the plan year.

Current New Pcori Fee Releasedlocity clients with Health Reimbursement Arrangement services through Paylocity should expect to receive an Average Covered Lives Report when the filing date nears. One other deadline looming is for calendar plan year health and welfare plans with 100 or more covered employees at the beginning of the plan year. The Form 5500 filing is due to the DOL by the end of the 7th month after the end of the plan year, normally July 31st. Since this date is a on Sunday in 2022, the due date falls on the next business day – August 1, 2022. Final return will be checked if the employer is going out of business, or no longer has a self-insured medical plan or HRA. However, the PCORI rules provide an exception to the fee requirement for an HRA where it is offered along with a self-insured major medical plan that has the same plan year as the HRA.

The IRS has published a table of the applicable filing deadline and rate for each plan year ending date. Influence clinical and healthcare research funded by others to be more patient centered. The annual PCORI fee must be reported and paid to the IRS by August 1, via the second quarter Form 720. $2.66 per covered life for plan years ending in January – September 2021. $2.54 per covered life for plan years ending in January – September 2020.







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