Tag: PCORI fee

On November 5, 2018, the Internal Revenue Service (IRS) released Notice 2018-85 to announce that the health plan Patient-Centered Outcomes Research Institute (PCORI) fee for plan years ending between October 1, 2018 and September 30, 2019 will be $2.45 per plan participant. This is an increase from the prior year’s fee of $2.39 due to…

Do you offer coverage to your employees through a self-insured group health plan? Do you sponsor a Health Reimbursement Arrangement (HRA)? If so, do you know whether your plan or HRA is subject to the annual Patient-Centered Research Outcomes Institute (PCORI) fee? This article answers frequently-asked questions about the PCORI fee, which plans are affected,…

Question: How do you calculate and submit the PCORI fee? Answer: Self-insured health plans are responsible for paying an annual fee multiplied by the average number of covered lives, including dependents. The plan sponsor may choose either of three methods for determining the average number of lives (see below). The following information regarding methods to determine…

Question: If a company has a fully insured medical benefit with a self-insured prescription benefit, are they required to pay Patient Centered Outcome Research Institute (PCORI) fees for both plans? Answer: According to the IRS regulations, this situation would require payment of two PCORI fees because the fully insured plan is subject to the fees…