PCORI fee reminder for self-insured groups
The Affordable Care Act (ACA) requires self-insured groups to pay a yearly fee that helps fund the Patient-Centered Outcomes Research Institute (PCORI). We suggest groups start preparing now, especially if you’re new to self-insurance and haven’t paid this fee before.
Which groups must pay the fee?
PCORI fees generally apply to all self-insured plans. However, they exclude HIPAA-excepted benefit plans such as standalone dental, vision and most health FSAs.
Note: HRAs are subject to separate fees filed by the employer if they are integrated with a fully insured group health plan. When the HRA is integrated with another self-insured plan, they are not subject to separate fees.
How much is the fee?
The IRS has provided a chart to help you find your fee, based on what month your plan ends.
How do groups make payment?
Groups must file directly with the IRS to make their payment.
When is the fee due?
Payments aren’t due until July 31, 2019. But now is a great time to familiarize yourself with the PCORI fee and how to calculate and make your payment.
- Employee Roster Report: Self-insured groups can obtain an employee roster report on the employer portal. Groups are able to calculate the number of covered lives using this report.
- 5500 Report: We will also provide form 5500 for groups who prefer this method. This option has specific calculations for plans providing self-only coverage.
Looking forward, the PCORI fee will end with plans that end in Sept. 2019. The last payment will be made in 2020.
To learn more about the fee, visit these helpful IRS resources: