PCORI Fees and Whether You Have to Pay Them

Beth Dean 11.01.12
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Health care reform’s Affordable Care Act (ACA) includes a provision in which fees are collected to fund research conducted by the Patient-Centered Outcomes Research Institute (PCORI). The research will evaluate effectiveness, risks, and benefits of medical treatments or services to allow the public to make more informed choices.

The fee will be assessed for plan years ending after September 30, 2012, through 2019. It is assessed at a rate of $1 per covered life for the first year, $2 per covered life the second year, then will be indexed to national health expenditures until it phases out in 2019. The fees must be reported to the IRS annually on Form 720 by July 31 of the calendar year immediately following the last day of the plan year.

Because the health plans of Nextep’s clients are fully-funded (rather than self-insured), the insurance provider will be solely responsible for calculating, reporting, and paying these fees. No further action is needed by plan sponsors.

For additional questions, please contact Nextep’s Benefits Department.

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