PCORI Fees Due July 31 for Self-Funded Insurance Plans – July 17, 2015 by Angel Rice


Posted by Angel Rice, CPA, MT, MAcc

The end of July is quickly approaching, and that means that business owners with self-funded accident, health or major medical insurance coverage and a plan year ended between January 1, 2014, and September 30, 2014, will need to pay their $2 per member PCORI fee. If your plan year ended between October 1, 2014, and December 31, 2014, your PCORI fee is $2.08 per member. Either way, the fee must be reported on Form 720 and is due July 31, 2015. This deadline cannot be extended.

A member is defined as all covered lives — employees, their spouses and their dependents. This is different than the definition used for Form 5500 participant count, which only counts employees.

There are three different methods that can be used to calculate the number of covered lives; you can use the one that is most beneficial to your situation. Note that the Snapshot factor is no longer a permissible calculation method, as it was last year.

1.) Actual count. Count the total number of covered lives for each day of the plan year; add them together and divide by the number of days in the plan year.

2.) Snapshot dates. Count the total number of covered lives on a single day on each quarter; add those together and divide by the number of dates on which a count was made.

3.) Form 5500 method (used only if Form 5500 will be filed prior to the deadline for the PCORI fee). For self-only coverage, combine the total participants at the beginning of the plan year with the total number of participants at the end of the year as reported on Form 5500; divide by two. For self only and other than self only, sum the total number of participants covered at the beginning and end of the year as reported on Form 5500.


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