The Affordable Care Act’s (ACA) Patient-Centered Outcomes Research Institute (PCORI) fee for policy or plan years that end between Oct. 1, 2018 and Oct. 1, 2019 is increased to $2.45 for payments due July 31, 2019. This is an increase from the $2.39 payment that was due in 2018. The PCORI fee is assessed on all covered lives – including employees, retirees, spouses and dependents.
The PCORI fee, which is effective from 2012 to 2019, helps fund research that evaluates and compares health outcomes, clinical effectiveness, risks and benefits of medical treatments and services.
- Fully insured: UnitedHealthcare is responsible for filing Form 720 and paying the fee for fully insured coverage. As the insurer, UnitedHealthcare will submit the required payment by July 31, 2019. Customers do not need to take any action.
Remember, fully insured customers with self-funded HRAs and FSAs are required to pay the fee on each employee covered under the account.
- Self-funded: Employers and plan sponsors are responsible for submitting IRS Form 720 and paying the PCORI fee by July 31 of the calendar year immediately following the last day of the plan year. The next payment is due July 31, 2019. Customers have access to:
Their entire population, not just the lives covered by UnitedHealthcare.
Form 5500 information or they may use the membership report from UnitedHealthcare Employer eServices to assist in the PCORI calculation.