PCORI Fee Indexed in IRS Notice 22-04

The Patient Centered Outcomes Research (PCOR) Institute created by the Affordable Care Act (ACA) was funded by a temporary fee on health plans.  While insurance companies typically take care of reporting and paying this fee for insured plans, an employer with a health reimbursement arrangement or a self-funded health plan is responsible to report and pay this fee each year by July 31 on IRS Form 720.

The fee started out at $1 per employee per year, then increased to $2 the second year, and then has indexed incrementally each year since.  The IRS has announced in Notice 22-04 that the next indexing amount is $2.79.  This essentially means by Monday, August 1, 2022 (since July 31 falls on a weekend):

  • Plan years ending during the first three quarters of 2021 will pay $2.66 per employee, and
  • Plan years ending during the fourth quarter of 2021 will pay $2.79 per employee.

It can be a bit confusing how the fee is based on plan year end date (rather than start date) and is not pro-rated for short plan years.  We have provided a chart below to help employers identify the fee and due date for a typical 12-month plan year based on plan year start date.

 

Self-Funded
Plan Year Ends
For a typical 12-month plan, Self-Funded Plan Year Began PCOR Fee Due to IRS on
Form 720 by
1/1/20 – 9/30/20 Non-CY Feb through Oct 2019 $2.54 Mon 8/2/21
10/1/20 – 12/31/20 Nov ’19, Dec ’19, or Jan ’20 $2.66 Mon 8/2/21
1/1/21 – 9/30/21 Non-CY Feb through Oct 2020 $2.66 Mon 8/1/22
10/1/21 – 12/31/21 Nov ’20, Dec ’20, or Jan ’21 $2.79 Mon 8/1/22
1/1/22 – 9/30/22 Non-CY Feb through Oct 2021 $2.79 Mon 7/31/23

 

While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept  liability  for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it. This publication is distributed on the understanding that the publisher is not engaged in rendering legal, accounting or other professional advice or services. Readers should always seek professional advice before entering into any commitments.


About Michelle Cammayo

Michelle Cammayo has more than 13 years of Employee Benefits experience specializing in all lines of health and welfare benefits. Today, Michelle works closely with clients and partners to provide guidance in areas of the law including ERISA, HIPAA, COBRA, FMLA and PPACA. She also oversees the Compliance Department at Bolton & Company to ensure we are helping our clients manage and eliminate risk with regards to employee benefit compliance.

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