UPDATE 12/19/19: On 12/19/19 Congress passed the Further Consolidated Appropriations Act, which extends the PCORI Fee to 2029. This means that employers with self-funded group health plans will continue to pay the fee until 2029 or 2030, depending on the plan year.
The Patient-Centered Outcomes Research Institute (PCORI) Fee, which was established as a part of the Affordable Care Act to fund medical research, was set to expire in 2020. The Senate has drafted legislation that would extend the PCORI fee for another ten years. The extension garners bipartisan support among lawmakers and will likely pass; however, given the current Congressional schedule, it is unclear when this will occur.
The PCORI fee is funded by insurers and employers with self-insured plans (including level funded plans and HRAs) through an annual fee. Employers who sponsor only fully insured plans do not pay the fee.
The last PCORI fee payment was supposed to be on July 31, 2019 for calendar year plans and July 31, 2020 for non-calendar year plans. The fee adjusts annually and the amounts due in 2019 are outlined below.
- For plan years that ended between September 30, 2017 through October 1, 2018, the fee was $2.39 per covered life.
- For plan years that ended between September 30, 2018 through October 1, 2019, the fee is $2.45 per covered life.
An extension would mean that employers with self-insured plans will need to continue making annual PCORI fee payments. These employers should be aware of the potential extension to ensure they submit the required PCORI fee if and when the extension passes.
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