Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due to the IRS no later than July 31, 2019 from employers who sponsor certain self-insured health plans, which includes all level funded as well as health reimbursement arrangements (HRAs) that are not treated as excepted benefits.

How to Pay PCORI Fees

Employers that sponsor certain self-insured health plans (Level Funded) must report and pay the required PCORI fees via IRS Form 720 along with HRA plans, Quarterly Federal Excise Tax Return. Complete Part II, line 133. Employers should note “2^nd Quarter” on the 720 form.

The fee applies to each Plan year that ends after October 1, 2012, and before October 1, 2019. “Plan year” refers to the plan year for your Level Funded Medical Plans or an HRA plan. Generally the plan year and the coverage period are the same. As an example, if your HRA benefit resets each January 1, your HRA plan year and your coverage period are generally a calendar year and end December 31.

There are three available methods that can be used to determine the average number of lives covered under a plan for the policy year. For an HRA plan it is acceptable to use the number of subscribers only. The most commonly used method is the Snapshot Method.

1. Actual Count Method: A plan sponsor may determine the average number of lives covered under a plan for a plan year by adding the totals of lives covered for each day of the play year and dividing that total by the total number of days in the plan year.
2. Snapshot Method: A plan sponsor may determine the average number of lives covered under an applicable self-insured health plan for a plan year based on the total number of lives covered on one date (or more dates if an equal number of dates is used in each quarter) during the first, second or third month of each quarter, and dividing that total by the number of dates on which a count was made.
3. Form 5500 Method: An eligible plan sponsor may determine the average number of lives covered under a plan for a plan year based on the number of participants reported on the Form 5500, Annual Return/Report of Employee Benefit Plan, or the Form 5500-SF, Short Form Annual Return/Report of Small Employee Benefit Plan.

Payments should be made payable to the U.S. Treasury and sent by July 31, 2019 to the applicable address on the attached instructions.

Tools to Assist you by Carrier:

All Savers

All Savers posts the employer group’s membership information to the employer website. The employer group is required to complete and file the IRS Form 720. For general questions please contact All Savers Broker Services at 1-866-405-7174.

Humana Level Funded

Click here.

Aetna Funding Advantage

This link takes you to your Producer World login and will assist in determining the fee due by your group.

Today, many of you received the important notice of the census reconciliation process required for all SOCA BP clients. This reconciliation must be completed by March 31, 2019. It has come to our attention that there was a programming error with regard to the census reconciliation process where you are unable to submit the month and year properly.

Please take note of the following information, which contains the fix to the programming issue in line 8 of the census:

• To fix the error, right-click on the blue cells in line 8.
• Right-click and select “Format Cells”.
• Select “General”.
• Click “OK”.

You must do this for both the “Month” cell and “Year” cell.

Click here to view the release from FormFire regarding the census reconciliation.