Health insurance issuers and self-funded group health plans must contribute to the Patient-Centered Outcomes Research Institute (PCORI).

Plan years that end on October 31, November 30, and December 31, 2015 must pay a PCORI fee of $2.17 by July 31, 2016.

The mandatory contribution for each plan year will be due July 31 the following calendar year, until the fee ends in 2019.

Specified Health Insurance or Applicable Self-insured Health Plans subject to the fee

Employers that sponsor a group health benefits should evaluate the plans they offer to determine which plans are subject to the PCORI fee, such as:

• A program offering accident or health coverage to individuals residing in the U.S. (called a “specified health insurance policy” or “applicable self-insured health plan”)
• An insurance policy or self-insured plan covering retirees and COBRA participants

IRS website for additional details on what plans are subject to the fee.

IRS Form for Payment of Fee

The PCORI fee must be reported and paid annually by filing Form 720, Quarterly Federal Excise Tax Return, by July 31 of the year following the last day of the policy year or plan year.

Electronic filing is available, but not required, and payment is due at the same time as Form 720.

It is very important to file with the appropriate Form 720 each year– do not use an old form.

* Policy years when the health plan is fully-insured

Issuers and plan sponsors required to pay the PCORI fee but are not required to report any other liabilities on Form 720 will be required to file Form 720 only once a year.

Issuers and plan sponsors required to report other liabilities on Form 720 will file one Form 720 for each quarter. The Form 720 filed in the 2nd quarter should be used to report and pay the PCORI fee due July 31.

Please note that the information contained in this document is designed to provide authoritative and accurate information, in regard to the subject matter covered. However, it is not provided as legal or tax advice and no representation is made as to the sufficiency for your specific company’s needs. This document should be reviewed by your legal counsel or tax consultant before use.

Additionally, the messages and content within the Pittsburgh Health Care Reform group do not reflect the advisory services of Henderson Brothers, Inc.