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The Wagner Law Group

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 22 attorneys engaged exclusively in employee benefits, estate planning and employment law. Six of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

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


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

315 Montgomery Street

Suite 904

San Francisco, CA 94104

 

St. Louis

Tel: (314) 236-0065

Fax: (314) 236-5743
100 South 4th Street, Suite 550
St. Louis, MO  63102 

 

www.wagnerlawgroup.com

 

 

 

 

October 22, 2015

 

 Health and Welfare Law Alert

 

 

 

  ACA's PCORI Fee Increases

  

 

 

 

The IRS has announced the latest Patient Centered Outcomes Research Institute ("PCORI") fee amount for policy and plan years that end on or after October 1, 2015, and before October 1, 2016.  Specifically, IRS Notice 2015-60 confirms that the new PCORI fee amount is $2.17 for policy and plan years ending after September 30, 2014, and before October 1, 2015.  This represents a 9 cent increase over the prior PCORI fee rate of $2.08.

  

 

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 the plan year that begins in 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, divided by 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).
  • The Form 5500 method (plan sponsor uses a certain formula that includes the number of participants actually reported on the Form 5500 for the plan year). 

Note:  The Form 5500 method is not available to sponsors that extend their filing deadlines beyond the July 31 due date for the PCORI fees.

 

 

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.

 

 

 

IRS Notice 2015-60 is available at: https://www.irs.gov/pub/irs-drop/n-15-60.pdf 

 

 

 

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.