PCORI Fees for 2021 Announced

4/14/2021

The Patient-Centered Outcomes Research Institute (PCORI) fee under the Affordable Care Act is due from sponsors of applicable self-funded health plans by July 31, 2021.  Applicable self-funded health plans include all health plans covering employees and retirees, as well as HRA, MRA, or prescription plans offered along with a fully insured group health plan.  It does not apply to ASR-administered health flexible spending accounts and exempt dental and vision plans.  Sponsors of applicable self-funded health plans will use Form 720 to report and remit the required fee, along with the related payment voucher, Form 720-V.

For plan years ending on January 31, 2020 through September 30, 2020, the fee payable by the plan sponsor is $2.54 for each covered life.  For plan years ending on October 31, 2020 through December 31, 2020, the fee payable by the plan sponsor is $2.66 for each covered life.  To see the complete list of plan years with their corresponding effective dates and fee amounts, select RESOURCES from the main menu of the ASR Website, and then select Health Care Reform and PCORI Fee by Plan Year.

ASR provides our employer groups with the necessary data to meet the PCORI fee obligation using the snapshot count method.  This calculation involves adding the total number of lives covered on the first day of each quarter of the plan year and dividing the total by four.  To access your data on our Website, follow these steps:

  1. Select Report Dashboard under the REPORTS item of the main menu and then select PCORI Fee (under Additional category). You will be directed to the PCORI Fee page.
  2. Select the first day of each quarter of your most recent plan year by clicking on the calendar icons next to Benefit Date 1, 2, 3, and 4.
  3. Click on the Get Report A report will be generated stating the total number of your covered members on each of the selected dates, as well as an average of the four enrollment counts (sum of the total number of covered lives on the first day of each quarter of the plan year divided by four).

If you have questions about this fee or the calculation method, call ASR Health Benefits at (616) 957-1751 or (800) 968-2449.

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