The Affordable Care Act (ACA) imposes a fee on health insurance issuers and plan sponsors of self-insured health plans to help fund the Patient-Centered Outcomes Research Institute (PCORI). The PCORI fee is calculated by multiplying the average number of lives covered under the policy or plan by the applicable PCORI amount.

 

Applicable Amounts for Reporting Due in 2022:

    • $2.79 for plan years ending on or after Oct. 1, 2021, and before Oct. 1, 2022 (see Notice 2022-04)
    • $2.66 for plan years ending on or after Oct. 1, 2020, and before Oct. 1, 2021 (see Notice 2020-84)

Due Dates:

    • Fees are due each year by July 31 of the year following the last day of the plan year.
    • Since July 31, 2022 falls on a Sunday, the PCORI fees are due by Aug. 1, 2022 for plan years ending in 2021.

Forms & Instructions:

    • PCORI fees are reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return – Q2) – see 2021 Form for reference only.
    • The IRS instructions for filing Form 720 include information on reporting and paying the PCORI fees – see 2021 Instructions for reference only.
    • Additional information can be found on the IRS’ PCORI Fee Overview and Q&A pages.​

Next Steps for Employers with Self-insured Health Plans:

    • Look out for the 2022 final form and instructions.
    • Work with your payroll provider (or other ACA reporting vendor) or accountant to submit the second quarter Form 720 and payment by the above-stated deadline.

As a reminder, health insurers file and pay on behalf of fully-insured health plans. 

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This blog and its contents are not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.