Employee Benefits Compliance, PCORI Fee

PCORI Fees: Summary and InDepth

One of the fees imposed on health plans by the Affordable Care Act (ACA) is the PCORI fee. PCORI stands for Patient-Centered Outcomes Research Institute. The ACA established the PCORI as an independent, nonprofit corporation to  objectively study and report on the effectiveness of various medical treatments. The Institute is funded in part by the annual fee imposed on all health plans:  Insured group health plans, individual policies and self-funded health plans, both grand-fathered & non-grandfathered. The fee is calculated based on the average number of enrollees (this includes employees, spouses and dependents). The amount of the fee is $1.00 per enrollee the first year, $2.00 per enrollee the second year, and thereafter will be indexed for inflation.  The PCORI fee is effective for plan or policy years ending on or after October 1, 2012 and before October 1, 2019, and is scheduled to end after that. July 31, 2013, was the date the first PCORI fee was due, and subsequent fees are due each year by July 31 for the prior year.

Prior Leavitt articles include a Summary of the PCORI fee and an InDepth article on the PCORI fee. The two PDFs attached here are updates of these earlier articles.

PCORI Fees Summary:   PCORI Fees Summary 4-10-2014

InDepth on PCORI Fees:  InDepth on PCORI 4-10-2014