X


Let's Talk

Let us help you make
an informed decision
Required:

How can we help you?

Looking for client support?
Click here instead.

UPDATE 12/19/19: On 12/19/19 Congress passed the Further Consolidated Appropriations Act, which extends the PCORI Fee to 2029. This means that employers with self-funded group health plans will continue to pay the fee until 2029 or 2030, depending on the plan year.

The Patient-Centered Outcomes Research Institute (PCORI) Fee, which was established as a part of the Affordable Care Act to fund medical research, was set to expire in 2020.  The Senate has drafted legislation that would extend the PCORI fee for another ten years. The extension garners bipartisan support among lawmakers and will likely pass; however, given the current Congressional schedule, it is unclear when this will occur.

The PCORI fee is funded by insurers and employers with self-insured plans (including level funded plans and HRAs) through an annual fee. Employers who sponsor only fully insured plans do not pay the fee.

The last PCORI fee payment was supposed to be on July 31, 2019 for calendar year plans and July 31, 2020 for non-calendar year plans. The fee adjusts annually and the amounts due in 2019 are outlined below.

  • For plan years that ended between September 30, 2017 through October 1, 2018, the fee was $2.39 per covered life.
  • For plan years that ended between September 30, 2018 through October 1, 2019, the fee is $2.45 per covered life.

An extension would mean that employers with self-insured plans will need to continue making annual PCORI fee payments. These employers should be aware of the potential extension to ensure they submit the required PCORI fee if and when the extension passes.

Additional Resources:

 

The information and materials on this blog are provided for informational purposes only and are not intended to constitute legal or tax advice. Information provided in this blog may not reflect the most current legal developments and may vary by jurisdiction. The content on this blog is for general informational purposes only and does not apply to any particular facts or circumstances. The use of this blog does not in any way establish an attorney-client relationship, nor should any such relationship be implied, and the contents do not constitute legal or tax advice. If you require legal or tax advice, please consult with a licensed attorney or tax professional in your jurisdiction. The contributing authors expressly disclaim all liability to any persons or entities with respect to any action or inaction based on the contents of this blog.

Emerald Law – Emerald is a Client Compliance Consultant for Sequoia, where she works with our clients to optimize and streamline benefits compliance. In her free time, Emerald enjoys stand-up comedy, live music and writing non-fiction.