The PCORI fee, filing and payment for plan or policy years ending in 2023 is due by July 31, 2024. The employer accomplishes the filing using the second quarter Form 720. A draft of the second quarter Form 720 can be found here. 

The PCORI fee is assessed on the average number of lives covered under the policy or plan. For policy and plan years ending between October 1, 2022, through October 1, 2023, the fee is $3.00 per covered life. For policy and plan years ending between October 1, 2023, through October 1, 2024, the fee is $3.22 per covered life. What this means is plans ending before October 1, 2023 use the $3.00 figure. Plan years ending between October 1, 2023, and December 31, 2023, use $3.22.

As background, the PCORI fee is assessed on the average number of lives covered under the policy or plan. Virtually, all health plans, whether insured or self-funded are subject to the PCORI fees. With regard to reimbursement type plans, health reimbursement arrangements (HRA) and medical flexible spending account (FSA) plans are subject to these fees. However, FSA plans that qualify as HIPAA-excepted plans are not subject to these fees. The PCORI fee does not apply to stand alone dental or vision plans.

The PCORI fees are assessed on the insurer of an insured plan. For a self-funded plan, the plan sponsor is required to pay the fee on behalf of its plan. Because the law provides that the PCORI fees are to be paid by the plan sponsor, at least for plans subject to ERISA, the fees cannot be paid from plan assets.

Additional information about the PCORI fee is available on the IRS’ dedicated PCORI webpage and Questions and Answers webpage.

The information contained in this Benefit Beat is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations. This information is provided as general guidance and may be affected by changes in law or regulation. This information is not intended to replace or substitute for accounting or other professional advice. You must consult your own attorney or tax advisor for assistance in specific situations. This information is provided as-is, with no warranties of any kind. CBIZ shall not be liable for any damages whatsoever in connection with its use and assumes no obligation to inform the reader of any changes in laws or other factors that could affect the information contained herein.