2024 Pay or Play Affordability Percentage

2023 PCORI Fee Amount

The Internal Revenue Service (IRS) issued Notice 2022-59 to increase the Patient-Centered Outcomes Research Institute (PCORI) fee amount. This fee amount affects plan years ending on or after October 1, 2022, and before October 1, 2023, with the amount increasing to $3.00 multiplied by the average number of lives covered under the plan.

PCORI fees are reported and paid annually using IRS Form 720, Quarterly Federal Excise Tax Return, by July 31st of each year. Employers with self-insured health plans should have reported and paid PCORI fees for 2021 by August 1, 2022, as July 31, 2022, fell on a Sunday.

Since PCORI fees are calculated based on the average number of covered lives under the plan or policy, employees and their enrolled spouses and dependents are generally included, except if the plan is considered a Health Reimbursement Account (HRA) or Flexible Spending Account (FSA). Alternatives for issuers and plan sponsors to determine the average number of covered lives has been outlined by final rules.

If you have any questions regarding the PCORI fee amount, please contact your dedicated Creative Benefits, Inc. team member.