What is PCORI?  The Patient Centered Outcomes Research Institute was established by Health Care Reform to conduct research on medical treatments, procedures, and services.  The institute will be funded by fees paid by plan sponsors (employers) and insurers.  

Plan Sponsors of self-funded medical plans and HRAs are required to complete IRS Form 720 and calculate and remit the applicable PCORI fee directly to the IRS by July 31st.  Because an HRA is considered a self-funded plan, the employer sponsoring the plan is required to calculate, submit and pay the fee for the HRA.  For your fully-insured benefits, the carrier of will calculate, file, and pay a separate fee.

The fee for policy and plan years depends on when your plan year ended, and the fees are due on July 31st following the calendar year in which your plan ended.

• Plans that ended between January 1, 2015 and September 30, 2015 have a fee of $2.08 per covered life.

• Plans that ended between October 1, 2015 and December 31, 2015 have a fee of $2.17 per covered life.

For self-funded employers, the average number of covered lives includes coverage provided for dependents and spouses.  For fully insured employers with an HRA plan, the fee is based on the average number of employees covered by the HRA (excluding dependents and spouses).   For those employers who sponsored self-funded or level-funded medical plans in conjunction with an HRA, you must pay the fee twice for every participant enrolled in both plans.