Annual PCORI Fee Reporting

PCORI Fee Overview: What You Need to Know

Under the Affordable Care Act (ACA), issuers of certain health insurance policies and sponsors of applicable self-insured health plans must pay an annual fee to fund the Patient-Centered Outcomes Research Institute (PCORI). This institute supports research that helps people and their providers make more informed healthcare decisions.

Annual Reporting & Due Date

The PCORI fee is reported once a year using IRS Form 720 and is due by July 31 following the end of the policy or plan year. The fee is calculated based on the average number of lives covered during that plan or policy year.

Fee Responsibility

• Fully insured plans: the insurer is responsible for filing and paying the fee
• Self-insured plans (including level-funded plans): the employer/plan sponsor is responsible for filing and paying
• Health Reimbursement Arrangements (HRAs) and Health Flexible Spending Accounts (FSAs):
  • If offered with a fully insured medical plan, employers must file and pay the PCORI fee
  • If paired with a self-insured medical plan, only the self-insured plan needs to be reported

Employer Filing Responsibilities

If you sponsor a self-insured medical plan, including a level-funded plan, you’re required to:

• File IRS Form 720 annually
• Calculate your average covered lives for the plan year
• Pay the PCORI fee directly to the IRS

HRA Filing Requirements

If you offer an HRA alongside a fully insured medical plan:

• You’re responsible for filing Form 720 and paying the PCORI fee
• Use your monthly billing statements to count the number of participating employees

If your HRA is paired with a self-insured health plan, no separate filing is needed for the HRA. Only the self-funded health plan information needs to be reported.

Payment Submission Process

Employers must complete and submit Form 720 for the second quarter of the calendar year. Submit the form and payment to the IRS by July 31 of the year following your plan year.

Example: for plan years ending in 2024, the PCORI fee and form are due by July 31, 2025.

Calculating the PCORI Fee

The PCORI fee is determined by multiplying the average number of covered lives during the policy or plan year by the applicable rate for your plan year:

• For plan years ending on or after October 1, 2023, and before October 1, 2024: $3.22 per covered life
• For plan years ending on or after October 1, 2024, and before October 1, 2025: $3.47 per covered life

Defining ‘Covered Lives’

• For self-insured plans, “covered lives” include participating employees and their dependents
• For HRAs and FSAs, only the number of participating employees is counted

 

Additional Resources

• Patient-Centered Outcomes Research Institute fee
• Patient-Centered Outcomes Research Trust Fund fee (IRC 4375, 4376 and 4377): Questions and answers
• https://www.govinfo.gov/content/pkg/FR-2012-12-06/pdf/2012-29325.pdf
• Form 720 Form and instructions

 

Page updated as of 4/30/2025.