We are writing to remind you of the upcoming Patient-Centered Outcomes Research Institute (PCORI) fee filing requirement, which applies to certain group health plans. The PCORI fee is a federally mandated annual fee that helps fund clinical effectiveness research and is reported to the IRS using Form 720.
For the 2026 filing cycle, the PCORI fee is due by July 31, 2026 and generally applies to plan years ending in 2025. Responsibility for filing and payment depends on your plan funding type:
- Fully Insured Plans: The insurance carrier is responsible for filing and paying the PCORI fee on your behalf. No action is required from the employer.
- Self-Funded Plans: The employer/plan sponsor is responsible for calculating, filing, and paying the PCORI fee directly to the IRS.
- Level-Funded Plans: The employer/plan sponsor is responsible for calculating, filing, and paying the PCORI fee directly to the IRS.
The amount of the PCORI fee is equal to the average number of lives covered during the policy year or plan year multiplied by the applicable dollar amount for the year.
- For policy and plan years ending after Sept. 30, 2025, and before Oct. 1, 2026, the applicable dollar amount is $3.84
- For policy and plan years ending after Sept. 30, 2024, and before Oct. 1, 2025, the applicable dollar amount is $3.47
How C2 Essentials Supports You
C2 Essentials will assist clients with calculating the PCORI fee amount due, including determining the average covered lives using an approved methodology. If you receive a notice about PCORI, please forward it to your C2 HR Team immediately where it will be reviewed for eligibility.
If you have any questions regarding your specific plan or the PCORI fee, please do not hesitate to contact us at 703-444-0096.