Self-Funded and Level Funded plans will need to continue to file PCORI fees for the next 10 years due to and extension of the law that was due to sunset in 2019. Deadline this year to file is July 31, 2020. Fully Insured plans generally have this filing done for them by Health Insurance Carriers.
The Affordable Care Act requires all medical plans sponsored by employers to pay a small fee annually, per member or you will pay a penalty. This fee goes to the Patient Centered Outcomes Research Institute (PCORI), which funds studies that improve health outcomes. Helping Americans to make better-informed healthcare choices.
Who must pay PCORI? All Medical Plans that are employer sponsored need to pay the fee. Fully Insured carriers generally include this amount in the premiums collected and pay it on behalf of the employers. Self-Funded, and Level-Funded type plans may need to file this. You should check with your carrier to be certain. Or, ask me and I’ll find out for you! I can assist with gathering the information for this filing.
Employers need to fill out IRS Form 720 for your plan, only filling out the relevant parts. Here is the schedule:
To calculate the fee, you will use 1 of 4 methods to find the average number of lives covered during your plan year. Fee above is per enrollee per year.
Please let me know if you need more information or assistance with your PCORI Filing!