In 2013, the Affordable Care Act (ACA) established an excise tax to be paid by employers with self-insured health plans. The plan sponsor is responsible for the reporting and payment of the fee, which is used to fund the Patient-Centered Outcomes Research Institute (PCORI), an initiative to improve health decisions by advancing comparative clinical effectiveness research. Employers that sponsor a self-insured health plan have until July 31, 2016, to submit an updated form (Form 720) and payment for the tax requirement.
How much do I owe?
The fee is determined based on your plan year ending. The fees are as follows:
| Plan year ending in 2015 | Fee per covered life | |
| Plan years ending on or after Jan. 1, 2015, through Sept. 30, 2015 |
$2.08 | |
| Plan years ending on or after Oct. 1, 2015 through Dec. 31, 2015, including calendar year plans |
$2.17 | |
Who is responsible for the fee?
Internal Revenue Code Section 4376 imposes a PCORI fee on self-insured health plans. Generally, this is any plan providing accident and health coverage other than through an insurance policy.
Below is a summary of plans for which the PCORI fee applies and those which are exempt:
| Plans subject to the fee | Plans exempt from the fee |
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How we can help
Do you know if your plan is subject to the fee? Do you need help filing Form 720? Contact Clark Schaefer Hackett’s Qualified Plan Administration and Consulting Group at 513-424-5000 for assistance with this requirement.
