Industry News

IRS PCORI Fee Updates

The article tracks the applicable PCORI fee amounts that self-funded employers are required to pay by plan year and the timing for those payments. The fee is used to fund comparative effectiveness research. The original PCORI fee expired in 2019 and was reinstituted for 2020 to 2029 by the Further Consolidated Appropriations Act, 2020. All health plans that provide Minimum Essential Coverage are subject to the PCORI tax/fee including plans that do not provide Minimum Value.

  • Fully insured plans – paid by health insurer
  • Self-funded plans – paid by employer

Employers pay the fee by July 31 in the calendar year after the end of the applicable plan year using Form 720 (Part II: Applicable self-insured health plans). Employers use one of two counting methods (Actual Count or Snapshot Dates) to determine the average number of lives covered. Most plan administrators provide simplified reporting to assist employers in computing their payment amount. Employers should contact their plan administrator.

  • Actual Count Method – Add total number of members covered for each day of the plan year and divide by the number of days in the plan year.
  • Snapshot Dates – Add total number of members covered on a date or dates during each quarter of the plan year and divide by the number of dates used. The dates used in each quarter must be within three days of the date used in the first quarter.

The table below represents the official fee amounts for each year and projected fees using the IRS inflation methodology. The applicable fee amount is determined by when the last day of the plan year occurs. Remember, a plan year ends on the day before the next plan year starts. E.g.: A 12-month plan year that begins on Oct 1 ends on Sep 30 the following year.

Plan Years EndingDue DateFee AmountActual or Projected?
Oct-Dec 2012Jul 31, 2013$1.00Actual
Jan-Sep 2013Jul 31, 2014$1.00Actual
Oct-Dec 2013Jul 31, 2014$2.00Actual
Jan-Sep 2014Jul 31, 2015$2.00Actual
Oct-Dec 2014Jul 31, 2015$2.08Actual
Jan-Sep 2015Jul 31, 2016$2.08Actual
Oct-Dec 2015Jul 31, 2016$2.17Actual
Jan-Sep 2016Jul 31, 2017$2.17Actual
Oct-Dec 2016Jul 31, 2017$2.23Actual
Jan-Sep 2017Jul 31, 2018$2.23Actual
Oct-Dec 2017Jul 31, 2018$2.39Actual
Jan-Sep 2018Jul 31, 2019$2.39Actual
Oct-Dec 2018Jul 31, 2019$2.45Actual
Jan-Sep 2019Jul 31, 2020$2.45Actual
Oct-Dec 2019Jul 31, 2020$2.54Actual
Jan-Sep 2020Jul 31, 2021$2.54Actual
Oct-Dec 2020Jul 31, 2021$2.65Projected
Jan-Sep 2021Jul 31, 2022$2.65Projected
Oct-Dec 2021Jul 31, 2022$2.78Projected
Jan-Sep 2022Jul 31, 2023$2.78Projected
Oct-Dec 2022Jul 31, 2023$2.91Projected
Jan-Sep 2023Jul 31, 2024$2.91Projected
Oct-Dec 2023Jul 31, 2024$3.21Projected
Jan-Sep 2024Jul 31, 2025$3.21Projected
Oct-Dec 2024Jul 31, 2025$3.38Projected
Jan-Sep 2025Jul 31, 2026$3.38Projected
Oct-Dec 2025Jul 31, 2026$3.54Projected
Jan-Sep 2026Jul 31, 2027$3.54Projected
Oct-Dec 2026Jul 31, 2027$3.71Projected
Jan-Sep 2027Jul 31, 2028$3.71Projected
Oct-Dec 2027Jul 31, 2028insufficient dataProjected
Jan-Sep 2028Jul 31, 2029insufficient dataProjected
Oct-Dec 2028Jul 31, 2029insufficient dataProjected
Jan-Sep 2029Jul 31, 2030insufficient dataProjected

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