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September 29, 2014
In Notice 2014-56, the IRS provided the new amount for the Patient-Centered Outcomes Research (PCORI) fees for plan years ending after Sept 30, 2014 and before Oct 1, 2015. The fee for such plan years is $2.08 (up from $2) multiplied by the average covered lives for the plan year. The carriers/insurers will pay the fee on behalf of fully-insured plans, but self-funded plans are responsible for paying the fee on behalf of any applicable group health plans.
The Affordable Care Act (ACA) created a new nonprofit corporation, the Patient-Centered Outcomes Research Institute (PCORI) to support clinical effectiveness research. It is funded in part by fees paid by health insurers and sponsors of self-funded health plans (PCORI fees).
PCORI fees apply to plan years ending after Sept 30, 2012 and before Oct 1, 2019. The fee is paid using quarterly Form 720 and must be paid no later than July 31 of the calendar year following the last day of the plan year.
The PCORI fee generally applies to all group health plans, but not to excepted benefits.
The amount of the fee differs based on plan year. The applicable fee for the year is multiplied by the average number of covered lives for the plan. Self-funded group health plans may determine the average number of covered lives using one of the following 3 methods:
Applicable Fee Amount
The applicable fee is:
IRS has set the fee for plan years ending after September 30, 2014 and before October 1, 2015 at $2.08. Further guidance will be provided indicating the fee for future plan years ending after September 30, 2015.
As always, should you have any questions, please contact your
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