Smart Benefits: PCORI Fee Due July 31
Rob Calise, GoLocalProv Business/Health Expert
Smart Benefits: PCORI Fee Due July 31
The Affordable Care Act created the fee to pay for research on the clinical effectiveness of medical procedures.
It is assessed for each plan year ending after September 30, 2012 and before October 1, 2019.
All plan sponsors of self-insured group health plans will pay the PCORI fee in 2019, but the amount of the fee will depend on when the plan year ends:
Insurers are responsible for calculating and paying the fee for fully-insured plans. For self-insured health plans and most HRAs, however, the employer is responsible for calculating and paying the fee. Payment is made by filing Form 720 by July 31st following the end of the calendar year in which the health plan year ends.
An HRA that is bundled with a fully-insured medical plan is subject to a separate fee. Although the insurer pays the fee for the underlying insured medical plan, the plan sponsor must pay a separate PCORI fee for the self-insured HRA. However, an HRA that is bundled with, and has the same plan year as, a self-insured major medical plan is not subject to a separate fee.
Under current law, the PCORI fee will not be assessed for plan years ending after September 30, 2019, which means that for a calendar year plan, the last year for assessment is the 2018 plan year. For non-calendar year plans that end between January 1, 2019 and September 30, 2019, however, there will be one last PCORI payment due by July 31, 2020.
The IRS has issued a legal opinion that the PCORI fee is a tax-deductible expense (under Code section 162(a)) for self-insured plan sponsors.
Rob Calise is the Managing Director, Employee Benefits of The Hilb Group of New England, where he helps clients control the costs of employee benefits by focusing on consumer-driven strategies and on how to best utilize the tax savings tools the government provides. Rob serves as Chairman of the Board of United Benefit Advisors, and is a board member of the Blue Cross & Blue Shield of RI Broker Advisory Board, United HealthCare of New England Broker Advisory Board and Rhode Island Business Healthcare Advisors Council. He is also a member of the National Association of Health Underwriters (NAHU), American Health Insurance Association (AHIA) and the Employers Council on Flexible Compensation (ECFC), as well as various human resource associations. Rob is a graduate of Bryant University with a BS in Finance
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