The Patient Centered Outcomes Research Institute (PCORI) was established as part of the Affordable Care Act (ACA) to conduct research to evaluate the effectiveness of medical treatments, procedures and strategies that treat, manage, diagnose or prevent illness or injury.

Under the ACA, most employer sponsors and insurers are required to pay fees that fund the institute until 2029, as it only applies to plan years ending on or before September 30, 2029 (unless extended). These fees are called PCORI fees.

Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2024 deadline for paying PCORI fees via Form 720, which was recently updated and released by the IRS.

The amount of PCORI fees due by employer sponsors and insurers is based upon the number of covered lives under each “applicable self-insured health plan” and “specified health insurance policy” (as defined by regulations) and the plan or policy year end date. This year, employers will pay the fee for plan years ending in 2023.

The fee is due by July 31, 2024 and varies based on the applicable plan year as follows:

• For plan years that ended between January 1, 2023 and September 30, 2023, the fee is $3.00 per covered life.
• For plan years that ended between October 1, 2023 and December 31, 2023, the fee is $3.22 per covered life.

Please reveiw the attached Legal Brief for more information or contact your NEEBCo Account Manager.