Certain Employers That Sponsor Group Health Plans Must Report And Pay The Patient-Centered Outcome Research Institute Fee By July 31, 2013


As previously mentioned in the June 11, 2013 edition of The Fast Laner, the Patient Protection and Affordable Care Act created the Patient-Centered Outcomes Research Institute (PCORI) that is to be partially funded through fees paid by health plans and health insurance issuers. Plan sponsors of self-insured health plans and health insurance carriers of fully-insured plans must pay the PCORI fee for seven years, beginning with plan years ending on or after October 1, 2012, and extending through plan years ending before October 1, 2019. The PCORI fee initially is $1 per covered life for the first plan year but increases to $2 per covered life for the second plan year. The fee must be paid no later than July 31 of the year following the last day of the plan year. Therefore, the first round of PCORI fees are due by July 31, 2013. This first due date of July 31, 2013 applies to group health plans with calendar plan years or non-calendar plan years that began between October 2, 2011 and December 31, 2011. For all other plan years, the applicable group health plan will not owe a PCORI fee until July 1, 2014. The PCORI fee is reported and paid on Internal Revenue Service Form 720. Employers that sponsor self-insured group health plans should confirm whether the upcoming July 31, 2013 deadline applies to their group health plan.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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