Smart Benefits: Self-Insured Deadline For PCORI Fee Looms

Rob Calise,GoLocalProv Business/Health Expert

Smart Benefits: Self-Insured Deadline For PCORI Fee Looms

The ACA requires that all medical plans pay the Patient-Centered Outcomes Research Trust Fund fee to the IRS. But while the insurance carrier pays the fee on behalf of policyholders for plans that are insured, employers/plan sponsors must pay it for self-insured plans. And it’s due July 31.

All self-insured medical plans, including health FSAs and HRAs, have to pay the fee unless it is an excepted-benefit:

•    FSAs are excepted-benefits if employers don’t contribute more than $500/year to the accounts and offer another medical plan with non-excepted benefits
•    HRAs are excepted-benefits they reimburses only for excepted-benefits (e.g., limited-scope dental and vision expenses or long-term care coverage) and are not integrated with the group medical plan. 

GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLAST

The fee – which funds the Patient-Centered Outcomes Research Institute’s efforts to assist patients, clinicians, purchasers and policymakers make informed health decisions by advancing the quality and relevant of evidence-based medicine – is $2.08 per covered life for plans ending on or after October 1, 2014, and before October 1, 2015, and $2.17 per covered life for plans ending on or after October 1, 2015, and before October 1, 2016. 

Plan sponsors of applicable self-insured health plans must file Form 720, Quarterly Federal Excise Tax Return, to report and pay the PCORI fee. Electronic filing is available but not required. 

Rob Calise is the Managing Director, Employee Benefits. of Cornerstone|Gencorp, 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.

RI Business Rankings in US

Enjoy this post? Share it with others.