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January 4, 2022
In Notice 2022-4, the IRS provided the adjusted PCORI fees for plan years ending in October 2021 through September 2022. Employers who sponsored self-funded medical plans that ended sometime during 2021 are required to report and pay the ACA Patient-Centered Outcomes Research Institute (PCORI) fees no later than July 31, 2022.
General summary information regarding PCORI fees can be found at opens in a new windowhttps://www.irs.gov/newsroom/patient-centered-outcomes-research-institute-fee.
Health insurance carriers pay the fee directly in the case of fully-insured plans, so employers offering only fully-insured group health plans do not have to do anything. However, employers are responsible for reporting and paying the fee for any self-funded group health plans, including HRAs. The PCORI fee applies to most group health plans, but not to excepted benefits. The IRS published a chart that describes the different types of plans subject to the fee here – opens in a new windowhttps://www.irs.gov/newsroom/application-of-the-patient-centered-outcomes-research-trust-fund-fee-to-common-types-of-health-coverage-or-arrangements.
The fee is paid using quarterly excise tax Form 720, Line 133, and must generally be paid no later than July 31st of the year following the last day of the plan year. If any corrections need to be made for prior years, use Form 720X.
Payment amounts due in 2022 will differ based on the employer’s plan year. The fees due in July 2022 are as follows:
The IRS put together a chart showing applicable fee amounts depending on the plan year end date at opens in a new windowhttps://www.irs.gov/affordable-care-act/patient-centered-outreach-research-institute-filing-due-dates-and-applicable-rates. NOTE – this chart has not yet been updated to include the applicable rates for filings due in 2022.
Self-funded plans may use one of three methods to determine the average covered lives used for reporting and paying the PCORI fee: (i) the actual count method; (ii) the snapshot method; or (iii) the Form 5500 method. There are special rules that apply for employers offering multiple self-funded plans or an HRA integrated with a fully-insured plan.
For more details on the PCORI fees, see our summary found here –
opens in a new windowhttps://www.benefitcomply.com/resources/2021/05/27/pcori-fee-summary/
Notice 2022-4 may be found here: opens in a new windowhttps://www.irs.gov/pub/irs-drop/n-22-04.pdf
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