United Benefit Advisors Insight and Analysis Blog

PPACA Update: Highlights of the PCORI Fee

By Bill Olson, VP, Marketing & Communications at United Benefit Advisors
  Jun 26, 2014 10:41:00 AM

describe the imageThe Patient-Centered Outcomes Research Institute (PCORI) fee is due July 31, 2014, for virtually all group medical plans.

Who is responsible for this fee?

The carrier is responsible for paying the fee on insured policies, and the employer/plan sponsor is responsible for paying the fee on self-funded plans [including Health Reimbursement Arrangements (HRAs)]. IRS Form 720 is used to report and pay the fee.

What is PCORI? 

PPACA created a private, non-profit corporation called the Patient-Centered Outcomes Research Institute (PCORI). The Institute’s job is to research the comparative effectiveness of different types of treatment for certain diseases, and to share its findings with the public and the medical community. The goal is to improve quality of treatment and reduce unnecessary spending. The fee is to support this research.

The PCORI fee applies from 2012 to 2019. The fee is due based on plan/policy years ending on or after October 1, 2012, and before October 1, 2019. The fee is due by July 31 of the year following the calendar year in which the plan/policy year ended. This means that the first fee was due July 31, 2013, for those on November, December, and calendar year plan years. The first fee is not due until July 31, 2014, for those with plan years that start January 2 through October 1.

Get the latest information on fee start and end dates, calculation methods, reporting rules and more with UBA’s recently updated PCORI resources, including:
 

1.  Highlights of the PCORI Fee. For those interested in a condensed explanation of the PCORI fee, this document includes:

  • How the fee is calculated
  • Who the fee applies to
  • What is included in “group health coverage”
  • Options for calculating the fee

Download the free highlights now.
 

2.  Frequently Asked Questions (FAQ) about the PCORI Fee

View the FAQ now. 


3.  Comparison Chart of PCORI and TRF. Many employers are gearing up to comply with the new fees under the Patient Protection and Affordable Care Act (PPACA). UBA offers a comparison of the PCORI fee and the Transitional Reinsurance Fee (TRF) that gives a side-by-side comparison of each, including start and end dates, reporting methods, fee due dates, exclusions, calculation methods and more.

Request the PCORI and TRF Comparison Chart now.

 

For further information, please contact a UBA Partner Firm near you.

Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business