Preparing for PCORI

It’s almost PCORI time again.

July 31 is the deadline for most self-funded plan sponsors to pay their PCORI fees for 2014. PCORI, or the Patient Centered Outcomes Research Institute, was established through the Affordable Care Act. The institute performs research intended to help patients, providers and policy makers make more informed healthcare decisions. The PCORI fees fund this research.

To calculate your plan’s total responsibility, multiply the PCORI fee by the average number of lives covered under the plan for that year. This chart shows the rate that self-funded plans will pay for the plan year that ended in 2014:

Jan – Sept 2014 July 31, 2015 $2
Oct, Nov, Dec  2014 July 31, 2015 $2.08

Your Plan’s Responsibilities 

As a plan sponsor, you are responsible for calculating the amount due based on the average number of lives on your plan in 2014; filing the proper paperwork; and paying this fee.

Determining lives and payment: HealthFirst will calculate your average number of lives. You should have already received this number from your HealthFirst account manager. If you have NOT received this number, or do not agree with the number provided, please contact your account manager immediately.

Filing and paying:  File the second quarter Form 720 annually to report correct data and pay the applicable fee. If you have no other liabilities to report on a Form 720, you will be required  to file a Form 720 only once a year, and you will not   be required to file a Form 720 for the first, third or fourth quarters of the year.

Questions?  If  you need additional assistance in filing the forms, please contact your account manager. To make the process go smoothly and ensure you will meet the July 31 deadline, please request assistance ASAP.