Understanding PCORI and Its Importance

What is PCORI?

The Patient-Centered Outcomes Research Institute (PCORI) is an independent, nonprofit organization established by the Patient Protection and Affordable Care Act (ACA) in 2010. PCORI’s primary mission is to fund research that provides patients, caregivers, and healthcare providers with evidence-based information to make better-informed healthcare decisions. PCORI focuses on comparative clinical effectiveness research (CER), which compares the benefits and harms of different treatment options.

PCORI aims to:

Improve the quality and relevance of evidence available to help all stakeholders make informed health decisions.
Enhance healthcare delivery and outcomes by producing and promoting high-integrity, evidence-based information.
Foster a healthcare system where patients’ preferences, needs, and values are prioritized.

Who Must Pay PCORI Fees?

PCORI fees, also known as the PCOR fees or comparative effectiveness research fees, are required by the ACA to fund the institute’s operations. These fees are imposed on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans.

Entities Responsible for PCORI Fees

Insurance Companies: Insurance companies providing health insurance policies are required to pay PCORI fees on behalf of their insured plans.
Self-Insured Health Plans: Employers or plan sponsors that offer self-insured health plans are responsible for paying PCORI fees. This includes Health Reimbursement Arrangements (HRAs) and certain Flexible Spending Accounts (FSAs) that do not qualify as excepted benefits.

Calculation and Payment of PCORI Fees

The fee amount is determined based on the average number of lives covered under the policy or plan. For policies and plans ending on or after October 1, 2022, and before October 1, 2023, the fee is $3.00 per covered life. The fee must be reported annually on the IRS Form 720, “Quarterly Federal Excise Tax Return,” due by July 31, following the last day of the policy or plan year.

Ensure Your PCORI Filing Before the July 31 Deadline

At Benefits Compliance Consultants, we understand businesses’ complexities and challenges in maintaining compliance with federal regulations. The PCORI fee filing is a critical requirement that must not be overlooked, especially with the upcoming deadline.

Why Act Now?

Avoid Penalties: Failure to file PCORI fees on time can result in significant penalties and interest charges. However, timely compliance can easily avoid these additional costs.
Ensure Accuracy: Properly calculating the average number of covered lives can be complex, particularly for self-insured plans. Accurate filing ensures you pay the correct fee, avoiding overpayment or underpayment issues.
Simplify the Process: Navigating the intricacies of federal filings can be daunting. Our team of experts is well-versed in PCORI fee requirements and can streamline the entire process for you, ensuring compliance without stress.

How Can Benefits Compliance Consultants Help?

Expert Guidance: Our experienced consultants provide personalized guidance tailored to your specific plan structure, ensuring accurate fee calculation and filing.
Timely Filing: We handle the entire filing process on your behalf, guaranteeing that your PCORI fees are submitted on time every time.
Compliance Assurance: Our thorough understanding of regulatory requirements ensures that your business remains compliant, minimizing the risk of penalties.

Contact Us Today

Don’t let the July 31 PCORI filing deadline pass without taking action. Trust Benefits Compliance Consultants to professionally handle your PCORI fee filing. Contact us today to schedule a consultation and ensure your business stays compliant.

Learn more about our PCORI services and how we can assist you with PCORI compliance.

Stay Compliant, Stay Ahead

Securing compliance with PCORI requirements avoids potential penalties and demonstrates your commitment to following federal regulations and contributing to improved healthcare outcomes. Let Benefits Compliance Consultants be your trusted partner in navigating the complexities of PCORI fee filing.

Act now to ensure your PCORI fees are filed accurately and on time. Contact us today!

By BC2|2024-07-09T21:42:27-04:00July 9, 2024|Benefits Compliance Consulting, ERISA Compliance, PCORI|Comments Off

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Understanding PCORI and Its Importance

What is PCORI?