PCORI Fees Update

The IRS is raising the fee that insurance issuers or sponsors of self-insured health plans pay annually to fund the federal Patient-Centered Outcomes Research Institute (PCORI) trust fund. The fee applies to health plans for the preceding calendar year, and for plan years ending in 2022, PCORI fees are due by July 31, 2023.

The current annual fee adjustments are as follows:

  • For plan years that ended on or after Oct. 1, 2022, and before Oct. 1, 2023, (including calendar year plans), the fee is $3 per person covered by the plan, up from $2.79 a year earlier.
  • For plan years that ended on or after Oct. 1, 2021, and before Oct. 1, 2022, the fee is $2.79 per person, up from $2.66 the year before.

Fees are calculated per covered life, including covered dependents, retirees and COBRA participants. 

Self-insured employers pay the annual PCORI fee directly to the IRS—third-party administrators cannot report and pay the fee. For fully insured employers, the fee is paid by the insurance provider, although the cost may be factored into premium increases.

The fee was originally intended to apply only to plans with terms ending after Sept. 30, 2012, and before Oct. 1, 2019. However, as part of the Bipartisan Budget Act of 2019, annual PCORI filing and fees were extended for an additional 10 years, through 2029.