Specified health insurance policy issuers and plan sponsors of self-insured health plans must pay their PCORI fee by July 31, 2024, using their Form 720, Quarterly Federal Excise Tax Return. The amount of the fee depends on when the plan year ends.

Background

The PCORI fee was mandated by the Affordable Care Act to help fund research on the comparative effectiveness of medical treatments. The fees must be paid by July 31 following the last day of the plan year (e.g., for policy years and plan years ending on December 31, 2023, the fee is due by July 31, 2024).

The PCORI fee was originally scheduled to sunset on September 30, 2019. In December 2019, the Further Consolidated Appropriations Act of 2020 extended the PCORI fee for 10 years, so it continues to apply to all plan years ending on or before September 30, 2029.

Calculating PCORI fees

Under the ACA, issuers of specified health insurance policies (under IRC Section 4375) and plan sponsors of self-insured health plans (under IRC Section 4376) must pay PCORI fees calculated by using the average number of lives covered under the policy or plan multiplied by the applicable dollar amount for that policy or plan year.

For plan years ending on or after October 1, 2023, and before October 1, 2024, the fee is $3.22 per covered life (see Tax Alert 2023-1740). For policy years and plan years that end on or after October 1, 2022, and before October 1, 2023, the adjusted applicable dollar amount is $3.00.

Implications

Only a single Form 720 should be filed each quarter, so plan sponsors will need to coordinate with their tax department to make sure the PCORI fee is included with the Form 720 for the second quarter. Given the fee depends on the number of covered lives, employers should start gathering data on the number of covered lives now, so they can calculate and pay the fee by the July 31, 2024 deadline.