PCORI Fee Amount Adjusted for 2023
The Internal Revenue Service (IRS) has issued Notice 2022-04 to increase the Patient-Centered Outcomes Research Institute (PCORI) fee amount for plan years ending on or after Oct. 1, 2022, and before Oct. 1, 2023. The PCORI fee amount increased from $2.79 to $3.00 multiplied by the average number of lives covered under the plan.
PCORI Fees Background
The PCORI fee is imposed by sections 4375 and 4376 on health insurance issuers and self-insured plan sponsors and helps to fund the Patient-Centered Outcomes Research Trust Fund (PCORTF) created by the Affordable Care Act (ACA) and first applied for plan years or policy years ending after Sept. 30, 2012.
These fees were originally scheduled to expire for plan or policy years ending on or after Oct. 1, 2019. However, a federal spending bill enacted at the end of 2019 extended the PCORI fees for an additional 10 years. As a result, the PCORI fee will apply through the plan or policy year ending before October 1, 2029.
Payment Deadline
PCORI fees are reported and paid annually on IRS Form 720 (Quarterly Federal Excise Tax Return). These fees are due each year by July 31st of the year following the last day of the plan year. For plans ending in 2022, the next PCORI fee is due by July 31, 2023. Employers with self-insured health plans should have reported and paid PCORI fees for 2021 by Aug. 1, 2022 (since July 31, 2022, was a Sunday).
Calculating the PCORI Fee
The PCORI fees are calculated based on the average number of covered lives under the plan or policy. This generally includes employees and their enrolled spouses and dependents, unless the plan is an HRA or FSA. Final rules outline a number of alternatives for issuers and plan sponsors to determine the average number of covered lives.
|
Plan Years |
Fee |
Filing Due Date |
|
Plan years ending on or after |
$3.00 |
July 31, 2023 |
|
The fee is multiplied by the average number of lives covered under the plan |
||
KEY FACTS
Covered Plans
The PCORI fees generally apply to insurance policies providing accident and health coverage and self-insured group health plans.
Applicability Dates
The PCORI fee applies to plan or policy years ending after Sept. 30, 2012, and before Oct. 1, 2029.
Payment Deadline
PCORI fees are due for plan or policy years ending in 2022 on July 31, 2023.
Prev
