​By Constance Lemere, President, Employee Benefit Exchange, Corp​

If you sponsor a self-funded health plan, it’s time to mark your calendar—the deadline to submit your PCORI fee and IRS Form 720 is July 31, 2025.

What is the PCORI Fee?

The Patient-Centered Outcomes Research Institute (PCORI) was established by the Affordable Care Act (ACA) to support research that helps patients and providers make better-informed healthcare decisions. To fund this research, the ACA requires health insurers and employers offering self-funded health plans to pay an annual fee.

Who Needs to Pay?

• Self-Funded and Level-Funded Plans: Employers with these types of plans are responsible for calculating and submitting the PCORI fee to the IRS.

• Fully Insured Plans: If your organization has a fully insured medical plan, your insurance carrier will take care of this for you. No action is needed on your part.

Updated PCORI Fee Amounts

Depending on your plan year, the fee per covered life is:

• $3.47 for plan years ending between October 1, 2024 and September 30, 2025

• $3.22 for plan years ending between October 1, 2023 and September 30, 2024

How to Submit

1. Calculate the fee based on the average number of covered lives during the plan year.

2. Complete IRS Form 720.

3. Submit both the form and payment directly to the IRS by July 31, 2025.

Questions?

Reach out to your health insurance broker or carrier for guidance. And as always, consult your tax advisor or legal counsel to ensure compliance.

This information is provided for general guidance and is not intended as legal or tax advice.