PCOR Fee Indexed in IRS Notice 22-04
Dec 22, 2021
The Patient Centered Outcomes Research (PCOR) Institute created by the Affordable Care Act (ACA) was funded by a temporary fee on health plans.Ìý While insurance companies typically take care of reporting and paying this fee for insured plans, an employer with a health reimbursement arrangement or a self-funded health plan is responsible to report and pay this fee each year by July 31 on IRS Form 720.
The fee started out at $1 per employee per year, then increased to $2 the second year, and then has indexed incrementally each year since.Ìý The IRS has announced in that the next indexing amount is $2.79.Ìý This essentially means by Monday, August 1, 2022 (since July 31 falls on a weekend):
It can be a bit confusing how the fee is based on plan year end date (rather than start date) and is not pro-rated for short plan years.Ìý So we provide a chart below to help employers identify the fee and due date for a typical 12-month plan year based on plan year start date.
We provide a more comprehensive overview of how to calculate your PCOR fee each June, a little closer to the July 31 due date.Ìý But please let your IMA Benefits team know if you have any questions.
Self-Funded Plan Year Ends | For a typical 12-month plan, Self-Funded Plan Year Began |
|
Due to IRS on Form 720 by |
1/1/20 – 9/30/20 | Non-CY Feb through Oct 2019 | $2.54 | Mon 8/2/21 |
10/1/20 – 12/31/20 | Nov’19, Dec’19, or Jan’20 | $2.66 | Mon 8/2/21 |
1/1/21 – 9/30/21 | Non-CY Feb through Oct 2020 | $2.66 | Mon 8/1/22 |
10/1/21 – 12/31/21 | Nov’20, Dec’20, or Jan’21 | $2.79 | Mon 8/1/22 |
1/1/22 – 9/30/22 | Non-CY Feb through Oct 2021 | $2.79 | Mon 7/31/23 |
Ìý
Written by: KC Rippstein
IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information.
This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.