As per Notice 2023-70, 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, 2023 and prior to October 1, 2024. The fee will now be $3.22 per plan enrollee, up from $3.00 for the 2023 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. For plan years ending in 2023, PCORI is due by July 31, 2024. For plan years ending January 2024 through September 2024, PCORI fees are not due until July 31, 2025.
This breaks down more specifically as follows:
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.
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.
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