June 13, 2016
The PCORI Fee for the 2015 plan year is due on August 1, 2016. The fee is filed on IRS Form 720, the Quarterly Federal Excise Tax Return. The fee may be filed electronically or mailed to the IRS. For fully insured plans, the health insurance issuer will pay the fee. Employers with self-funded plans are generally responsible for paying the fee themselves, although some TPAs will collect and file the fee on employers’ behalf. Fully insured employers who also have an HRA are responsible for paying the fee levied on the HRA.
The PCORI Fee is due by July 31 following the end of the plan year. In 2016, July 31 is a Sunday so the fee is due on Monday, August 1. The amount of the fee depends on its plan year.
To determine the average number of lives (including employees, dependents, and COBRA enrollees) covered by a plan, employers can use one of three methods:
Special counting rules may be used for HRAs and FSAs. Employers may assume one covered life for each employee with an HRA or a FSA.
Health Saving Accounts (HSAs) and most Flexible Spending Accounts (FSAs) are not subject to the PCORI Fee, but Health Reimbursement Accounts (HRAs) are. Generally, a separate fee would apply for lives covered by each health insurance policy or self-funded plan. However, if an employer has multiple self-insured health plans with the same plan sponsor and the same plan year, such as a medical plan and an HRA, employers may treat those plans as a single applicable self-insured plan.
|Plan Year End Date||Fee Per Covered Life||Due Date|
|January 1, 2015 – September 30, 2015||$2.08||July 31, 2016|
|October 1, 2015 – December 31, 2015||$2.17||July 31, 2016|
October 20, 2022
On October 18, 2022, the Internal Revenue Service (IRS) released Revenue Procedure 2022-38, which increases the health flexible spending account (FSA) salary reduction contribution limit to $3,050 for plan years beginning in 2023, an increase of $200 from 2022. Thus, for health FSAs with a carryover feature, the maximum carryover amount is $610 (20% of the $3,050 salary […]
August 14, 2018
The Affordable Care Act (ACA) requires insurers who plan on modifying plan premiums to submit their rates to either the state or federal government for review. This applies to plans included on state and federal healthcare insurance exchanges. The rate review process is designed to improve insurer accountability and transparency. It ensures experts are evaluating whether the proposed rate […]