The Annual ACA PCORI Fees are Increasing in 2021
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The IRS has released the PCORI fee for plans that end on or after October 1, 2020 and before October 1, 2021.
For plans that end on or after October 1, 2020 and before October 1, 2021 the PCORI rate per covered individual is $2.66. This amount is up slightly from $2.54, which applies to plans that end on or after October 1, 2019 and before October 1, 2020.
The Patient-Centered Outcomes Research Trust Fund fee is a fee on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans that help to fund the Patient-Centered Outcomes Research Institute (PCORI), which was established by the Affordable Care Act (ACA). The institute assists, through research, patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence-based medicine. The institute compiles and distributes comparative clinical effectiveness research findings.
PCORI fees were originally slated to end this year, but the Further Consolidated Appropriations Act of 2020 that was signed by the Trump Administration extended the fees through September 30, 2029.
The PCORI fee on an insurer is calculated off the average number of lives covered under the policy. The fee imposed on sponsors of a self-insured health plan is based on the average number of lives covered under the plan. That means that insurers or plan sponsors must account for all parties enrolled in their respective policy of plan, such as dependents, spouses, retirees, and COBRA beneficiaries. Factors such as when the plan starts and ends can also contribute to determining the fee per form.
PCORI fees are imposed on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans to fund the Patient-Centered Outcomes Research Institute (PCORI), which was established under the Affordable Care Act (ACA). The institute assists, through research, patients, clinicians, purchasers and policy-makers, in making informed health decisions by advancing the quality and relevance of evidence-based medicine. The institute compiles and distributes comparative clinical effectiveness research findings.
On an annual basis, organizations must pay PCORI fees by July 31 and do so by using Form 720. The IRS states that the fee should be paid using the Electronic Federal Tax Payment Systems (EFTPS).
For more information from the IRS on the PCORI fee click here.
Employers that need assistance in calculating PCORI fees should contact us to learn about ACA Complete. With a full-service ACA compliance solution such as ACA Complete, PCORI fees are determined and calculated at no extra cost.
To learn more about ACA compliance in 2021, click here.
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