Jun 18, 2024
Background
The Patient-Centered Outcomes Research Institute (PCORI) fee helps fund research that evaluates and compares health outcomes, clinical effectiveness, and the risks and benefits of medical treatments and services. Under the Affordable Care Act (ACA), health insurers, and plan sponsors are responsible for paying the PCORI fee. Self-funded (ASO) plan sponsors must file Form 720 and pay the PCORI fee directly to the Internal Revenue Service (IRS).
The fee is due by July 31 of the calendar year following the last day of the plan year.
More information about PCORI fees is available from Amwins Connect, including a May 2024 Brief.
Membership Reports for UnitedHealthcare and Oxford Level Funded
UnitedHealthcare and Oxford Level Funded Groups with plan years ending in 2023 have been provided a PCORI Membership Report to assist in the PCORI fee filing. The membership report includes the plan's monthly membership count for the 2023 year, along with membership calculations using two of the allowable counting methods. Customers must determine which counting method they wish to use and then complete and file the IRS Form 720 by July 31, 2024.
To access the reports:
- Visit UHCeServices.
- Navigate to the "Reports" drop-down menu.
- Select "Level Funded."
- Go to the "PCORI Membership Report" section.
Important Note: it is possible for a group to have two PCORI Membership Reports if their plan renewed in 2023 and the group then terminated their plan later in the year. Plan sponsors should be sure they have accessed all available PCORI Membership Reports.
For additional questions about PCORI Fees, review the informational links above or contact your Amwins Connect Regional Sales Manager.
