Patient-Centered Outcome Research Institute

News & Analysis as of

2015 End of Year Plan Sponsor “To Do” List Health & Welfare

As 2015 comes to an end, we are pleased to present you with our traditional End of Year Plan Sponsor “To Do” Lists. Like last year, we are presenting our “To Do” Lists in three separate Employee Benefits Updates. Part 1 of...more

IRS Adjusted ACA Fee Amounts for the 2015/2016 Policy or Plan Years and Additional Payment Options

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance...more

PCORI Fee Inflation Adjustment

In Notice 2015-60 (October 9, 2015), the IRS announced that the PCORI fee will rise to $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016. For plan years ending on or after...more

Recent Health Plan and Other Updates

Much Ado About the Cadillac Tax - Recently there have been many parties, including certain presidential candidates, weighing in on the Affordable Care Act’s Excise Tax on High Cost Health Benefits under Code section...more

IRS Provides Q&As on PCORI Fee

The IRS has provided Q&As regarding the Patient-Centered Outcomes Research Institute (PCORI) fee. The fee applies to issuers of specified health insurance policies as well as plan sponsors of applicable self-insured health...more

More Cadillac Plan Tax Guidance from IRS

Code § 4980I (a/k/a/ the “Cadillac Plan tax”) was added by the ACA so that taxpayers with average group health plans would not subsidize, by tax preference, rich plans benefitting chiefly the rich. Section 4980I imposes a...more

Employee Benefits Alert - July 2015

Major Revisions to Qualified Plan Determination Letter Process Announced - Effective January 1, 2017, the staggered five-year determination letter remedial amendment cycles for individually designed plans will be...more

Patients' Voices Carry: Drug Development Increasingly Driven by Patients' Needs and Concerns

With the recent announcement of Sarepta’s filing for approval of its drug, eteplirsen, for the treatment of Duchenne muscular dystrophy (DMD), coming on the heels of BioMarin’s announcement a few months earlier of a similar...more

July and August 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

IRS Notice 2015-43 Addresses Expatriate Health Coverage

New guidance from the Internal Revenue Service (IRS) leaves in place the limited Affordable Care Act (ACA) exemptions set out in the Expatriate Health Coverage Clarification Act of 2014 (EHCCA). IRS Notice 2015-43 (Notice)...more

Deadline Looms for New PCORI Grant Applications

Wednesday the Patient-Centered Outcomes Institute announced the availability of up to $76 million in new grant money for comparative effectiveness research projects. But the deadline for prospective applicants to submit...more

Upcoming Health and Welfare Plan Requirements Checklist for Employers

As the mid-way point of 2014 approaches, employers should actively turn their attention to several upcoming compliance obligations for the health and welfare benefit plans they sponsor. Below is a checklist of upcoming...more

Departments Release Guidance on Dental and Vision Plans, EAPs, and "Wraparound" Coverage

On December 20, 2013, the Departments of Treasury, Labor, and Health and Human Services (collectively, the Departments) jointly issued proposed rules (Proposed Regulations) that would amend the regulations regarding excepted...more

Reminder: PCORI Fee Due July 31 for Employers With Self-Insured Health Plans

As previously reported, the Patient Protection and Affordable Care Act (the “ACA”) established the Patient Centered Outcomes Research Institute (the “PCORI”) for the purpose of assisting patients, clinicians, purchasers and...more

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

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...more

First Payment Of Employer's PCORI Fees For Self-Insured Health Insurance Plans Due July 31

The first payment of the Patient-Centered Outcomes Research Institute (PCORI) fee imposed by the Affordable Care Act is due next week on July 31st. While the U.S. Treasury Department has delayed implementing certain health...more

PCORI Fee Payment and Filing Deadline is July 31, 2013

The Affordable Care Act has established a new annual fee, imposed on group health plans, which will be used to fund the Patient Centered Outcomes Research Institute. The amount of the fee is $1 times the average number of...more

The Employer’s Playbook for Affordable Care Act Compliance: Self-Insured Plans - Remember - July 31, 2013 Deadline for Paying...

Media coverage of the one year delay in certain Affordable Care Act provisions might mislead some employers into thinking they have no obligations. Many requirements still take effect this year and in 2014. Here is one of the...more

PCOR Trust Fund Fee Due Soon for Many Plans

Calendar-year plans should use updated IRS Form 720 and related instructions to file by July 31 deadline. Under the Affordable Care Act (ACA), for plan years ending on or after October 1, 2012, plan sponsors of...more

Important Reminder Regarding PCORI Fees

An important deadline is looming under the Affordable Care Act (ACA) for employers that sponsor certain self-insured group health plans and issuers of certain health insurance policies. Under the ACA, employers and insurers...more

ACA’s “Pay-Or-Play” Penalty Delayed Until 2015

Last week, in a move welcomed by many employers, the Obama administration announced that it would delay implementation of certain key provisions of the Affordable Care Act (ACA) until 2015....more

Health Care Reform Employer Mandate Delayed; DOMA Struck Down - What Now For Employers?

Health Care Reform Employer Mandate and Reporting Provisions Delayed until 2015 - The U.S. Department of the Treasury unexpectedly announced on July 2, 2013 the delay of the employer shared responsibility ‘pay or play’...more

Employers Face Compliance Options In Lights Of Delayed Implementation Of Pay Or Pay Mandate Under The ACA, But Other ACA...

On July 2, 2013, the Treasury Department’s announced that enforcement of the "Pay or Play" mandate under the ACA will be delayed until January 1, 2015. This announcement was followed by a brief notice from the IRS which...more

The ERISA Litigation Newsletter - July 2013

As Amy Covert and Aaron Feuer discuss below, the U.S. Supreme Court granted certiorari in Heimeshoff v. Hartford Life & Accident Insurance Co. where it is expected to rule next term on whether plan sponsors may dictate in the...more

IRS Guidance Released on the Delayed Implementation of the Affordable Care Act's Play or Pay Rules - Penalties Will Not Apply to...

On the heels of last week’s announcement that the Affordable Care Act’s (ACA) reporting requirements and Play or Pay penalties will not go into effect until 2015, the IRS has released transition relief clarifying that the...more

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