PCORI Fees 2023

Important Reminder:

The Further Consolidated Appropriations Act signed into law in December of 2019 extended the PCORI Fee for another 10 years, through 2029.

All self-funded groups (including level-funded and HRA plans) will be required to report and pay the PCORI fee to the IRS through Form 720.

Plan sponsors need to complete and file the IRS Form 720 by July 31, 2023 for the plan year preceding.

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Prior year PCORI fees can be found here- The updated fees are noted below:

• Plan years ending between January 1, 2022 and September 30,2022: $2.79 per covered life.
• Plan years ending between October 1, 2022 and December 31, 2022: $3.00 per covered life.

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Self-insured plan sponsors can calculate the average number of covered lives using either:

• Actual Count method – This method requires a plan sponsor to count the actual covered lives on each day of the plan year and divide by the number of days in the plan year.
• Snapshot method – Choose one or more days during each calendar quarter, add the covered lives on those dates and divide by the number of dates used. Sponsors must use the same number of dates in each quarter, and the dates must be within three days of the comparable date in the other quarters.
• 5500 method – Sponsors who offer only individual coverage can take the number of participants reported at the beginning of the plan year, plus the number reported at the end of the plan year and divide by two. Plan sponsors who offer coverage other than individual coverage must take the number of participants reported at the beginning of the plan year, plus the number reported at the end of the plan year. Sponsors wanting to use this method should be sure the relevant Form 5500 will be filed by July 31 – extensions are not permitted.

Once you have your membership total: Total Medical covered Lives X Fee Per Average Covered Life = PCORI Fee.