PCORI Fees
What are PCORI fees and which employer plans pay them?
PCORI (Patient-Centered Outcomes Research Institute) fees are annual fees imposed on health insurance issuers and self-insured health plan sponsors to fund comparative clinical effectiveness research. Created by the Affordable Care Act, PCORI fees apply to plan years ending on or after October 1, 2012. The fee for plan years ending in 2026 is approximately $3.47 per covered life. Self-insured health plans report and pay through Form 720; fully insured plans pay through the carrier.
PCORI fees are one of those niche ACA compliance items that mostly hits self-insured employers and gets handled by the broker or third-party administrator on fully insured plans. The fee is small per covered life ($3.47 for plan years ending in 2026) but applies to every covered person including dependents. For self-insured employers, the filing happens annually on Form 720 by July 31. Missing the filing produces penalties; the IRS treats PCORI as a regular excise tax.
Which Plans Pay PCORI Fees
Self-insured group health plans (sponsor pays). Fully insured plans (carrier pays, builds into premium). HRAs that aren't integrated with a group health plan. Excepted benefits (dental, vision, EAP) are generally exempt.
How the PCORI Fee Is Calculated
Per covered life times the applicable rate. 2026 rate (for plan years ending Oct 2025-Sep 2026) is $3.47. Calculate average covered lives using one of three IRS-allowed methods: actual count, snapshot, or Form 5500.
Form 720 Filing for Self-Insured Plans
Self-insured plan sponsors file Form 720 by July 31 of the year following the plan year end. Pay PCORI fee with the filing. The filing covers the previous plan year. See payroll for tax reporting context.
Building PCORI Compliance Into Your Annual Cycle
Calendar the July 31 filing deadline. Calculate covered lives using consistent method. Coordinate with TPA on self-insured plans. For fully insured, verify the carrier handled it. See employee benefits and Health Care FSA for related health plan compliance. IRS reference: irs.gov/pcori.
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