The Wagner Law Group
Wagner Law Group, A Professional Corporation, is a nationally
recognized ERISA & employee benefits, estate planning,
employment, labor & human resources practice.
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.
Wagner Law Group
Fax: (561) 293-3591
7108 Fairway Drive
Palm Beach Gardens, FL 33418
East Kennedy Boulevard
Tampa, FL 33602
Francisco, CA 94104
100 South 4th Street, Suite 550
St. Louis, MO 63102
October 22, 2015
Health and Welfare Law
ACA's PCORI Fee
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.
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
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
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.
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