If a group had a self-funded plan for part of the year, how is PCORI handled?
The Patient-Centered Outcomes Research Institute (PCORI) fees are still applicable to self-insured health plans that had short plan years. The PCORI fee for a short plan year is equal to the average number of lives covered during the plan year multiplied by the applicable dollar amount. You may calculate average number of lives covered using one of three methods:
- Actual Count Method: Add the total number of lives covered for each day of the plan year and divide that by the total number of days in the policy year.
- Snapshot Method: Choose one or more days during each calendar quarter, and add the lives covered during each of those dates and then divide by the number of dates used. You must use the same number of dates in each quarter and the dates must be within three days of the comparable dates in the other quarters.
- Form 5500 Method: Use the number of participants reported on a plan’s Form 5500 provided the Form 5500 is filed no later than July 31.