The IRS released the dollar amount that is used to calculate the Patient Centered Outcomes Research Trust Fund fee for plan years that end on or after October 1, 2018 and before October 1, 2019. The fee has increased to $2.45.
The Affordable Care Act created the Patient-Centered Outcomes Research Institute (PCORI) to improve the quality of health care and provide information to help consumers make informed health care decisions. Most health plans must pay an annual fee to fund PCORI research. An exception is made for stand-alone dental or vision plans, EAPs, wellness programs, plans for employees outside of the U.S., HSAs, and almost all HRAs and FSAs. The next PCORI fee is due July 31, 2019.
If a health plan is fully insured, the insurer is responsible for paying the PCORI fee. If the health plan is self-funded, the plan sponsor (employer) must pay the fee.
A self-funded health plan determines the applicable fee by multiplying the fee amount by the average number of total lives covered by the plan.