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PCORI Fees Reminder: Due July 31, 2014

March 2017

Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2014 deadline for paying fees that fund the Patient-Centered Outcomes Research Institute ("PCORI"). As background, PCORI was established as part of health care reform to conduct research to evaluate the effectiveness of medical treatments, procedures and strategies that treat, manage, diagnose or prevent illness or injury. PCORI fees were first due by sponsors of self-insured group health plans and insurers last July for plan and policy years that ended on or after October 1, 2012. Under health care reform, most employer sponsors and insurers will be required to pay PCORI fees until 2019.
The amount of PCORI fees due by employer sponsors and insurers is based upon the number of covered lives under each "applicable self-insured health plan" and "specified health insurance policy" (as defined by regulations) and the applicable plan or policy year.

  • For plan years that ended between October 1, 2012 and December 31, 2012, the fee for each covered life was $1 and was due July 31, 2013.
  • For plan years ending between January 1, 2013 and September 30, 2013, the fee is $1 per covered life and is due by July 31, 2014.
  • For plan years ending between October 1, 2013 and December 31, 2013, the fee is $2 per covered life and is due by July 31, 2014.
  • NOTE: The insurance carrier is responsible for paying the PCORI fee on behalf of a fully insured plan. The employer is responsible for paying the fee on behalf of a self-insured plan, including an HRA.

To learn more about the impact of this and other health care reform decisions, please visit Peel & Holland University, where we have posted a document titled PCORI Fees Reminder: Due July 31, 2014.

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