PCORI Filing for 2023?

Hey there, HR superheroes! Today, let’s shed some light on those pesky PCORI fees and make the process a breeze for you. PCORI stands for the Patient-Centered Outcomes Research Institute, and the fees are a part of the Affordable Care Act (ACA) requirement. If your company offers a self-insured health plan, these fees help fund research that compares different medical treatments to improve patient outcomes. But don’t worry, we’re here to answer your burning questions and demystify this process!

Commonly Asked Questions:
1. What are PCORI fees, and why do we have to pay them?
PCORI fees are annual charges imposed on self-insured health plans and certain health insurance policies. They fund the Patient-Centered Outcomes Research Institute, an independent organization dedicated to enhancing medical decision-making through research. By contributing to this cause, you’re supporting studies that lead to better healthcare choices and improved patient well-being.

2. Who is subject to PCORI fees?
If your company sponsors a self-insured health plan or offers certain health insurance policies, you’re likely subject to PCORI fees. Self-insured health plans cover the medical expenses of employees rather than relying on an insurance carrier, and these plans can be offered by larger organizations seeking more control over their healthcare benefits.

3. How do I calculate the PCORI fees, and when are they due?
Calculating the fees may sound daunting, but fret not! For self-insured health plans, you can use one of two methods: the “Actual Count” method or the “Snapshot” method. The first one involves counting the number of covered lives each day of the plan year, while the second entails an average count on a chosen date each quarter. The fees are typically due by July 31st of the year following the end of the plan year, so mark your calendars! There is more information on how to calculate the fees in the downloadable whitepaper below.

Navigating the world of PCORI fees doesn’t have to be a headache. By understanding the “what” and “why,” and with a bit of record-keeping and math magic, you can fulfill your filing duties with ease. Remember, we’re always here to lend a helping hand. So, HR superheroes, go forth and conquer those PCORI fees like the champions you are!

Download the PCORI Whitepaper HERE

If you are looking for assistance with HR and Compliance, Advanced Benefits has solutions. You can partner with our team to identify outsourcing solutions, establish best practices, and more.

This blog post was prepared for Advanced Benefits by Arwyn Robinson. As the Director of Marketing for Advanced Benefits, Arwyn handles all things marketing, internal and external communications, social media, content creation, graphic design, and event coordination. Arwyn has been in the insurance industry since 2012 and enjoys the challenge that the ever-changing landscape has to offer. She has her Bachelor’s in Business Administration, SHRM-CP, and is a Certified Self-Funded Specialist.