PCORI Fees

Do you have a self-insured group medical plan?
Do you have a fully-insured health plan with a Health Reimbursement Arrangement (HRA)?

Employers that sponsor self-insured group health plans including health reimbursement arrangements (HRAs) should take note of the July 31, 2015 deadline for paying fees that fund the Patient Centered Outcomes Research Institute (PCORI). This was established as part of health care reform to conduct research to evaluate the effectiveness of medical treatments and will continue until 2019.

The amount due is based on the number of covered lives under each “applicable self-insured health plan” and “specified health insurance policy”.

  • For plan years that ended between January 1, 2014 and September 30, 2014, the fee is $2.00 per covered life and is due by July 31, 2015.
  • For plan years that ended between October 1, 2014 and December 31, 2014, the fee is $2.08 per covered life and is due by July 31, 2015.
  • The fee will be paid by July 31, 2016 for any plan years ending in 2015.
  • 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. 

Employers should report and pay PCORI fees using IRS Form 720, quarterly federal excise tax return.

Health and Welfare Benefit Plan: Form 5500 Filing Requirements

Did you have over 100 participants on your group health plan at the beginning of your plan year?
Does your plan renew on January 1?

A Form 5500 contains information about your health plan(s), the plan sponsor, how it is funded, contributions, etc. Most employers are familiar with filing a Form 5500 for the retirement plan. It is also a requirement to file a Form 5500 if you have 100 or more participants (employees) on your group health plan at the beginning of the plan year. The Form should be filed by the last day of the seventh month after the start of the plan year. As the majority of plans renew in January, the deadline to file is July 31st. You can file a Form 5558 on or before that date and request a 2 ½ month extension if needed.

Forms can be filed electronically using the EFAST2 system at www.efast.dol.gov.


More information on health benefit and retirement Form 5500 filling requirements at http://www.irs.gov/Retirement-Plans/Form-5500-Corner