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The Wagner Law Group

The Wagner Law Group is a nationally recognized practice in the areas of ERISA and employee benefits, estate planning, employment, labor and human resources and investment management.

 

Established in 1996, The Wagner Law Group is dedicated to the highest standards of integrity, excellence and thought leadership and is considered to be amongst the nation's premier ERISA and employee benefits law firms. The firm has seven offices across the country, providing unparalleled legal advice to its clients, including large, small and nonprofit corporations as well as individuals and government entities worldwide. The Wagner Law Group's 29 attorneys, senior benefits consultant and four paralegals combine many years of experience in their fields of practice with a variety of backgrounds. Seven of the attorneys are AV-rated by Martindale-Hubbell and six are Fellows of the American College of Employee Benefits Counsel, an invitation-only organization of nationally recognized employee benefits lawyers.  Seven of the firm's attorneys have been named to the prestigious Super Lawyers list for 2017, which highlights outstanding lawyers based on a rigorous selection process.

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Boston 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110

 

Washington, D.C.

Tel: (202) 969-2800

 

Fax: (202) 969-2568

 800 Connecticut Avenue, N.W.

Suite 810

Washington, D.C. 20006

 

Chicago

Tel: (847) 990-9034

Fax: (847) 557-1312

190 South LaSalle Street

Suite 2100

Chicago, IL 60603

 

  

Palm Beach Gardens 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

Tampa

Tel: (813) 603-2959

Fax: (813) 603-2961

101 East Kennedy Boulevard

Suite 2140
Tampa, FL  33602 

  

San Francisco

Tel: (415) 625-0002

Fax: (415) 358-8300

300 Montgomery Street

Suite 600

San Francisco, CA 94104

  

St. Louis

Tel: (314) 236-0065

Fax: (314) 236-5743
25 W. Moody Avenue
St. Louis, MO  63119 

 

 

www.wagnerlawgroup.com

 

 

 

 

 ACA's PCORI Fee Increases

November 21, 2017

 

 

 

IRS Notice 2017-61 provides that the latest Patient Centered Outcomes Research Institute ("PCORI") fee amount for policy and plan years that end on or after October 1, 2017, and before October 1, 2018 is $2.39.  This represents a 13 cent increase over the prior PCORI fee rate of $2.26.

  

 

Background.  The Affordable Care Act ("ACA") imposes a fee (the "PCORI fee") on fully-insured and self-insured plans that provide accident or health benefits to individuals living in the U.S.  While the insurer is responsible for paying the PCORI fee for fully-insured plans, employers and employee organizations that maintain self-insured plans are also subject to the fee with respect to those plans. 

 

 

 

The PCORI fee supports the Patient Centered Outcome Research Trust Fund, which will conduct comparative effectiveness research.  The PCORI fee was first assessed for plan years ending after September 30, 2012.  The PCORI fee for the first plan year was $1 per covered life, and increased to $2 per covered life in the second year.  For subsequent plan years, the PCORI fee is adjusted to reflect inflation in National Health Expenditures, as determined by the Secretary of Health and Human Services. 

 

 

 

The PCORI fee will not be assessed for plan years ending after September 30, 2019.  For calendar year plans, this means that the last year of the PCORI fee will be 2018.

 

 

 

Calculating the PCORI Fee Amount.  The PCORI fee amount is equal to the average number of lives covered during the policy or plan year multiplied by the applicable dollar amount for the year. 

 

 

 

Plan sponsors may use any of the following methods to calculate the average number of covered lives under the plan:

 

  • The actual count method (plan sponsor adds the totals of lives covered for each day of the year, and divides the total by the number of days in the plan year).
  • The snapshot method (plan sponsor adds the total lives covered on one date in each quarter of the plan year and divides by four).
  • The Form 5500 method (plan sponsor uses a formula that includes the number of participants actually reported on the Form 5500 for the plan year). 

 

Paying the Fee.  Plan sponsors of self-funded plans must remit the PCORI fee to IRS annually along with an IRS Form 720.  The payment and form must be remitted to IRS by July 31 for all plan years ending in the preceding calendar year.

 

 

 

 

 

 

 

 

 

This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.

 

This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.