The Patient-Centered Outcomes Research Institute (PCORI) fee was created to help fund research that provides patients, caregivers, employers and policy makers information to make more informed health decisions. The fee is effective for 2012-2019.
The PCORI fee is the responsibility of the insurer. The insurer must file the IRS Form 720 and pay the fee to the IRS by July 31 of the calendar year immediately following the last day of the plan year. Instructions on how to fill out the Form 720 can be found HERE. The 2018 fee is $2.39 for each life subject to the fee.
Self Funded Plans
In self funded plans, employers and plan sponsors are responsible for submitting Form 720 and paying the PCORI fee. Therefore, it is important that you file the Form 720 by the July 31 deadline.
Level Funded Plans
There has been a great deal of confusion regarding who is responsible for filing the Form 720 and paying the PCORI fees for level funded plans. It is important to note that level funded plans are a type of self funded plan. Therefore, employers and plan sponsors are responsible for submitting Form 720 and paying the PCORI fees for level funded plans.
Fully Insured Plans
If you currently have a fully insured plan, your insurer is responsible for filing the IRS Form 720 and paying the fee. Therefore, you are not required to file the Form 720. However, if you are fully funded and have a self-funded HSA or FSA you are required to pay the fee on each participant in the account.
If you are unsure about whether you utilize a fully funded or self funded plan, please get with your broker to determine you liability as it relates to the PCORI fee.