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IRS releases new guidance adjusting the PCORI fee dollar amount

IRS releases new guidance adjusting the Patient-Centered Outcomes Research Institute (PCORI) fee dollar amount
The ACA created the nonprofit Patient-Centered Outcomes Research Institute to help health care providers and others evaluate and compare health outcomes, clinical effectiveness, and the risks and benefits of treatments. To fund this research, the ACA is charging a fee to certain health insurers (those who offer fully insured plans) and plan sponsors of self-insured health plans.

The ACA created the nonprofit Patient-Centered Outcomes Research Institute to help health care providers and others evaluate and compare health outcomes, clinical effectiveness, and the risks and benefits of treatments. To fund this research, the ACA is charging a fee to certain health insurers (those who offer fully insured plans) and plan sponsors of self-insured health plans.

On September 19, 2014 the IRS updated the amount of the PCORI fee for policy years and plan years ending on or after October 1, 2014, and before October 1, 2015. The adjusted applicable dollar amount has been updated to $2.08 per covered life. This is an increase of eight cents over the dollar amount applicable for policy years and plan years ending on or after October 1, 2013, and before October 1, 2014. The amount of the fee will continue to be adjusted for inflation going forward until the PCORI fee ends on October 1, 2019.

As a reminder, BCBSMA will file the federal Excise Tax Return Form 720 and pay the fee by the due date on behalf of all our fully insured accounts. For our self-insured accounts, plan sponsors must calculate, report, and pay the PCORI fee. Under the IRS final rule, third parties may not file Form 720 or pay the fee to the IRS on behalf of plan sponsors. Going forward, the fee will be due on July 31 of the year following the last day of the policy or plan year. While we cannot calculate, report, or pay the PCORI fee for self-insured accounts, we can provide snapshot enrollment data for many through our self-service reporting tool, ReportBlue. For more information on this report and how to use it, please go to ReportBlue under Manage Your Account. If you have an account with a Blue Funding Solution arrangement, please remind them to call you for additional information regarding the PCORI fee.

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