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PCORI Fees Extended for 10 Years

We said goodbye to the old decade and we thought we were kissing PCORI fees goodbye as well, but instead we are saying hello to a new decade AND a new decade of PCORI Fees!

The Affordable Care Act established the Patient-Centered Outcome Research Institute (PCORI) to perform research and support clinical effectiveness research. PCORI is funded in part through fees paid by various health insurers and employers sponsoring self-insured health plans.

The Further Consolidated Appropriations Act, 2020, signed into law on December 20, has reauthorized those fees for the next ten years, meaning that insurers and employers will have to continue to pay this fee until 2029 or 2030, depending on their plan year. The amount due per life covered under a policy will continue to be adjusted annually.

We’ve posted blogs about the PCORI fees and explained that this past summer the IRS had announced that the adjusted applicable amount is $2.45 for policy or plan years ending on or after Oct. 1, 2018, and before Oct. 1, 2019.

Originally under the Affordable Care Act, the fees would no longer have applied for plan years beginning after October 1 of this year, but the reauthorization ensures that the fees will be around for the next decade. While insurance carriers are responsible for paying the fees for fully-insured plans, employers are responsible for self-insured health coverage. That includes HRAs and health FSAs, so employers will want to refamiliarize themselves with when the fees apply and how to calculate what is owed.

To learn more about calculating and paying PCORI fees, click here to visit the IRS website.

For FAQs, click here. Need our help? Let us know.