PCORI Fees: Who Pays, Rates and Form 720 Deadlines

The PCORI fee funds comparative health research through the Patient-Centered Outcomes Research Trust Fund. For U.S. group coverage, insurers pay for specified fully insured policies; employers sponsoring applicable self-insured plans generally pay for those plans. Multiply average covered lives by the IRS rate for the year ending date, then file Form 720 and pay by July 31 of the following calendar year.

Who pays, and which arrangements need review?

The IRS PCORI questions and answers distinguish insurance issuers from self-insured plan sponsors. Level-funded arrangements generally require the self-insured sponsor to address the fee; stop-loss insurance does not make the medical plan fully insured. A third-party administrator may help calculate lives, but confirm filing responsibility in writing.

An HRA paired with fully insured medical coverage may create a separate sponsor obligation. Excepted-benefit dental or vision plans and most health FSAs are excluded. Certain employee assistance, disease-management and wellness programs are excluded if they do not provide significant medical benefits. Do not assume every FSA or supplemental arrangement qualifies.

Which rate applies?

The IRS rate table, checked October 21, 2026, lists these rates. Select by plan or policy year ending date, not the filing year. Do not extend a listed rate to later ending dates without checking the IRS.

Example: an applicable self-insured calendar-year 2025 plan with 100 average covered lives owes 100 × $3.84 = $384. Form 720 and payment were due July 31, 2026. A plan ending September 30, 2025 instead uses $3.47, even though its filing also falls in 2026.

How do you count lives and file?

Self-insured sponsors may use the actual count, snapshot or Form 5500 method, subject to each method's conditions. Insurers also have member-months and state-form methods. Covered dependents, COBRA participants and retirees generally count, not just employees. Special HRA and FSA rules may apply; document the method rather than using employee headcount.

1. Confirm the plan year, funding status and applicable arrangements.
2. Reconcile enrollment data and retain the counting calculation.
3. Use the current second-quarter Form 720 to report the annual fee and pay by July 31 following the year the plan ends.
4. Follow current payment instructions. Form 720-V is a payment voucher where applicable, not an attachment required for every payment method. PCORI deposits are not required.

Coordinate the filing calendar with employer HR compliance support. Software does not reduce the statutory rate or replace the approved counting rules.

General information, not legal, tax, or medical advice; plan documents and current rules control.

For employer plan support, request a group health insurance quote.