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prescription drug reporting

Important PCORI Deadline Information

What is the PCORI Fee?

  • The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute to study clinical effectiveness and health outcomes. To finance the nonprofit institute’s work, a small annual fee is charged on health plans.

 Who pays PCORI Fees?

  • Employers that self-insure a Health Plan or an HRA, and commercial group health insurance providers are responsible for paying the fee.
  • It is important to note for self-funded, level funded and standalone HRA plans, the carrier will NOT remit this fee for your clients nor will your clients be invoiced. Third-Party Administrators are prohibited under the health reform law from remitting the fee for employers. As such, we have outlined the Fee Schedule and remittance information so you can advise your clients how to calculate, report, and pay this fee.

When are PCORI fees due and how are they calculated?

  • For Plan Years that ended on or after January 1, 2021 through December 31, 2021, PCORI Fees are due by July 31, 2022.
  • PCORI Fees are based on when a Plan Year ends and the number of covered lives.

For Plan Years that END Oct. 2021 through Sept. 2022 – Fee Per Covered Life $2.66

How do employers report and pay the fee?

Form 720
Form 720 Instructions

Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.