PCORI Fees

Question

Which group health plan sponsors are required to report PCORI Fees to the IRS?

Answer

Fully insured carriers and most self-funded/level funded health plan sponsors must pay annual Patient Centered Outcomes Research Institute (PCORI) fees to the IRS. They are also required to report the same on Form 720 as an excise tax. The payment is due by July 31st of each year.

As of this article, IRS Form 720 on the IRS website has not yet been updated with the latest fees for plan years ending on or after October 1, 2025. The IRS normally provides an updated form closer to the reporting deadline date.

Other than fully insured carriers and self-funded/level funded health plan sponsors, what other plans may be required to report?

When the HRA is integrated with a fully insured medical plan, the employer plan sponsor submits payment for all employees (no dependents) enrolled in the HRA.

An FSA is not subject to the PCORI Fee if it meets the requirements of an 'excepted benefit'.

PCORI Fee Amounts

• $3.47 for plan years ending on or after January 1, 2025, through September 30, 2025 - Filing date July 31, 2026
• $3.84 for plan years ending on or after October 1, 2025, through December 31, 2025 - Filing date July 31, 2026
• $3.84 for plan years ending on or after January 1, 2026 through September 30, 2026 - Filing date July 31, 2027

Resources

• Amwins Benefits - Compliance Library
• Amwins Benefits - PCORI Fee Brief
• IRS Chart on Plans Subject to PCORI Fees (IRS.gov)

^{While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it. This publication is distributed on the understanding that the publisher is not engaged in rendering legal, accounting, or other professional advice or services. Readers should always seek professional advice before entering into any commitments.}