As in years past, all self-funded employer health plan sponsors are required to file and pay their Patient-Centered Outcomes Research Institute (PCORI) fee no later than July 31, 2020.
As part of the Further Consolidated Appropriations Act of 2020, Congress last year extended the requirement that health plans file and pay the PCORI fee through September 30, 2029. And on June 8, the Internal Revenue Service (IRS) released the updated fees due this summer.
All self-funded plan sponsors are required to pay a fee based on the average number of covered lives under their eligible plans – including employees, retirees, spouses, and dependents.
- Self-funded plans subject to the requirements include self-funded medical benefit plans, including most non-ERISA self-funded plans and retiree-only plans.
- Other self-funded plans subject to the fee include self-funded HRAs and FSAs which are not integrated with a plan sponsor’s self-funded major-medical plan.
- Dental-only, vision-only, EAP, disease management, and wellness plans are exempt.
If the process remains the same as in prior years, plan sponsors must use the IRS Form 720 dated April 2020 to record and remit the amount due. (To our knowledge, the IRS has not yet released the revised April 2020 IRS Form 720.) When preparing the form, make sure to complete the correct section of Part II for “Applicable self-insured health plans” and select the correct payment amount based on your plan’s plan year end date.
This year’s payment schedule can be found at MedBen.com along with more information about calculating and remitting the fee to the IRS. As always, if you need more information about how to count covered lives under your plan or how to prepare and remit your payment, don’t hesitate to contact your Account Management Team or the MedBen Compliance Department.