Health Plans Must Pay PCORI Fees by Aug 1

Health insurers and self-insured plans are responsible for paying the annual fee

By By Kimberley Mitchell and Richard Stover © Xerox HR Consulting June 28, 2016

Each year, plan sponsors of self-insured group health plans must pay a fee to fund the federal Patient-Centered Outcomes Research Institute (PCORI). Plan sponsors should prepare to report and pay this fee by the Aug. 1, 2016, deadline.

The Affordable Care Act requires plan sponsors of self-insured group health plans and issuers of health insurance plans to pay a fee to help fund PCORI, which conducts research to evaluate and compare the health outcomes and clinical effectiveness, risks and benefits of medical treatments, services, procedures and drugs.

The fee applies to plan years ending after Sept. 30, 2012, and before Oct. 1, 2019, and is based on the average number of lives covered under the plan.

2016 PCORI Fee Amount​

Last November, the Internal Revenue Service announced in IRS Notice 2015-60 the employer fees paid to fund PCORI. The fee amount varies depending on when the plan year ends.

For self-insured plans, the fee is due no later than July 31 of the year following the last day of the plan year and will vary depending on when the plan year ends. (For 2016, when July 31 falls on a Sunday, the fee is due by Aug. 1.)

Plan Year

Fee per Covered Life

Plan years ending on or after Oct. 1, 2015, through Dec. 31, 2015, including calendar year plans


Plan years ending on or after Jan. 1, 2015, through Sept. 30, 2015


Plan sponsors should use Form 720 (and related instructions) to report and pay the PCORI fee by Aug. 1, 2016.

Kimberley Mitchell, JD, is a director in the Knowledge Resource Center of Xerox HR Services. Richard Stover, FSA, MAAA, is a principal and actuary at Xerox HR Services. © 2016 Xerox Corp. All rights reserved. Republished with permission.

Related Resource:

Are You Ready to Pay the PCORI Fee?, ABD Insurance & Financial Services, June 2016

Related SHRM Article:

PCORI & Reinsurance Fees—Keeping Them Straight, SHRM Online Benefits, June 2013

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