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2022 PCORI Fee Amounts Announced

12/26/2021 Written by: Nathanael M. Alexander, Esq.

As per Notice 2022-04, the IRS is adjusting the fee that insurers or self-insured health plan sponsors will pay to fund the federal Patient-Centered Outcomes Research Institute (PCORI) trust fund for plan years ending on or after October 1, 2021 and prior to October 1, 2022. The fee will now be $2.79 per plan enrollee, up from $2.66 for the 2021 plan year. The annual fee is paid using quarterly excise tax Form 720 and must be remitted to the IRS no later than July 31st of the year following the last day of the plan year, which includes calendar-year plans.

This breaks down more specifically as follows:

  • $2.66 per covered life for plan years ending in January through September of 2021 (reported on IRS Form 720, Line 133(c)).
  • $2.79 per covered life for plan years ending in October through December of 2021 (reported on IRS Form 720, Line 133(d)).
  • $2.79 per covered life for plan years ending in Feb 1, 2021 through October 1, 2021 (reported on IRS Form 720, Line 133(d)).

Please note that for plan years ending in 2021, the traditional July 31st deadline has been extended to Monday, August 1st since this particular July 31st falls on a Sunday. For additional information on when PCORI is due for your plan and the applicable rate that must be utilized to perform the calculations please see the IRS’ guidance here

From an applicability standpoint not much has changed—and, fully-insured health plans are reminded that they are still not responsible for paying PCORI. The IRS Chart found here illustrates the various health coverage types and arrangements subject to the PCORI fee.

For fully insured employers, the fee is paid to the IRS by the insurance provider, although the cost may be factored into any applicable premium increases. Whereas self-insured employers (including employers with fully insured medical/Rx plans that include a self-funded HRA) are responsible for paying the annual PCORI fee directly to the IRS along with an IRS Form 720. (Note: The IRS has not yet updated Form 720 with the new rate for 2022).

You may recall that PCORI was previously due to sunset in 2019, but was extended by Congress through 2029. 

If you are looking for more specific details on how to calculate PCORI, please feel free to refer to the IRS’ calculation methodologies here or contact your AssuredPartners Account Manager for assistance.

Links:

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