Patient-Centered Outcomes Research Institute Fees

Health care regulations impose a fee on sponsors and issuers of group health plans, including HRAs, called the Patient-Centered Outcomes Research Institute (PCORI) fee. Since an HRA is considered a self-insured group health plan, the plan sponsor (usually the employer) is responsible for reporting and paying the PCORI fee each year.

When is the fee due?
PCORI fees are due July 31 of the year following the last day of the plan year (including a short plan year). Refer to irs.gov for more information.

Example:
HRA plan year is 01.01.2021-12.31.2021 – plan sponsor must file no later than 07.31.2022.
HRA plan year is 09.01.2020-08.31.2021 – plan sponsor must file no later than 07.31.2022.

How much is the fee?
PCORI fees are based on the average number of lives covered under the plan. For applicable PCORI fees refer to irs.gov.

How is the fee calculated?
Special counting rules for the HRA assumes one covered life per account when the HRA is subject to PCORI fees.

For HRA plans integrated with another self-insured major medical plan:

  • If both integrated plans have the same plan year, plan sponsors are not required to pay separate PCORI fees for the HRA plan.
  • If the integrated plans have different plan years, plan sponsors are required to pay PCORI fees for the HRA plan.

For HRA plans integrated with another fully-insured major medical plan:

  • Plan sponsors are required to pay the PCORI fees for the HRA plan.

How do I access my HRA plan participant numbers?
Log in to the Alerus employer website and select Reports>New Report>Account Balance Report.

Additional Resources and References

This information is intended to reference IRS regulations surrounding PCORI fees and is not legal advice. Consult your attorney or benefits broker if you have any further questions regarding PCORI fees.