Understanding PCORI Fees: A Comprehensive Guide to ACA Health Insurance

The Affordable Care Act (ACA) has brought about significant changes to the healthcare landscape in the United States. One aspect of the ACA that businesses may not be aware of is the Patient-Centered Outcomes Research Institute (PCORI) fees. These fees help fund research to improve the quality and efficiency of healthcare in the country.

What are PCORI Fees?

PCORI fees are assessed on health insurance plans that provide coverage to more than 50 employees in a calendar year. The fees are calculated based on the number of covered lives and are used to fund research projects that aim to improve patient outcomes and healthcare quality.

When are PCORI Fees Due?

PCORI fees are due in two installments:
– First installment: Due by July 31st of each calendar year
– Second installment: Due by November 30th of each calendar year

How are PCORI Fees Calculated?

The PCORI fees are calculated based on the number of covered lives under the health insurance plan. The fee is $2.36 per covered life for health insurance plans that provide coverage through commercial insurance companies. For self-funded plans, the fee is $2.54 per covered life.

Who is Responsible for Paying PCORI Fees?

The employer or health insurance carrier is responsible for paying PCORI fees. Employers with self-funded plans are directly responsible for paying the fees, while employers with commercial insurance plans may pass the fees on to the health insurance carrier.

Benefits of PCORI Fees

PCORI fees contribute to funding valuable research that aims to improve the quality and efficiency of healthcare in the United States. These research projects can:

Identify treatments and interventions that improve patient outcomes
Develop tools and guidelines to support better decision-making in healthcare
Promote health equity and reduce disparities in healthcare outcomes

Seeking Help for ACA Health Insurance

If you have any questions or need assistance with ACA health insurance, it is recommended to contact a licensed insurance agent. Licensed agents can provide expert guidance and help you understand the details of PCORI fees and other ACA provisions.

Question? or Need a Free Quote?
Contact Us

Reach out to us for free expert insurance advice and solutions. We will help you solve ACA (Obamacare) related questions and problems. Will contact you within 24 hours of receiving your message.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *