Healthcare Reform Updates

Updated PCORI Fee Released

Blog post

Who: Employers who sponsor applicable self-insured health plans

What: The new adjusted PCORI Fee is $2.39 per covered life for plans ending on or after October 1, 2017

When: The next PCORI fee is due July 31, 2018

The IRS has released (Notice 2017-61) which provides the adjusted PCORI fee for plan years endig on and after October 1, 2017 and before October 1, 2018.

Employers who sponsor only fully insured heath pla

ns are not required to take any action to pay the PCORI fees; instead, health insurers/carriers will pay the fee. Employers who sponsor self-insured health plans are responsible for paying the fee for certain health coverages. For a chart of common health coverages or arrangements that are subject to the PCORI fee and the responsible party for reporting and payment, please click here.

The PCORI fee is paid using IRS Form 720. The PCORI fee has increased over several years due to inflation and payments are due based on the end of the plan/policy period. The most recent PCORI fee amounts and applicable plan years are summarized below. 

  • $2.39 per "covered life" for plan years ending on or after October 1, 2017 and before October 31, 2018. (e.g., plan year end December 31, 2017)
  • $2.26 per "covered life" for plan years ending on or after October 1, 2016 and before October 31, 2017.
  • $2.17 per "covered life" for plan years ending on or after October 1, 2015 and before October 1, 2016.

One of three methods, the actual count, snapshot or Form 5500 methods, must be used to calculate the number of covered lives which determines the fee amount due. Special counting rules for covered lives may apply when a self-insured employer has multiple applicable self-insured health plan. Special counting rules also apply to health flexible spending accounts (FSAs) and Health Reimbursement Arrangements (HRAs).  

For more information on these counting rules, and the PCORI fee in general, please see the IRS PCORI fee website.