The Patient-Centered Outcomes Research Institute (PCORI) fee might seem like one of the more straightforward compliance items on your HR calendar. Applicable employers and plan sponsors use the second-quarter Form 720 to make the required payment by July 31 each year.
But that simplicity can also make it easy to overlook.
Whether you’re new to managing health plans or want to double-check your PCORI compliance processes, this quiz can help you assess your readiness.
PCORI fee preparedness
1. Is your health plan subject to the PCORI fee?
A. Yes. I know whether our plan is fully insured or self-insured, and how that status affects who pays the PCORI fee. I’m also aware that health reimbursement arrangements with fully insured medical plans could require a PCORI fee for employee participants.
B. I think so, but I’m not 100% sure.
C. I know we offer health coverage, but I’m unfamiliar with the PCORI fee.
2. Do you know your plan’s year-end date?
A. Yes. Our organization documents and reviews the start and end of our plan year annually. I understand that the PCORI fee is determined by the last day of the plan year.
B. I think so, but I haven’t double-checked the date.
C. I’m not sure where to find that information.
3. Have you selected a method to calculate the average number of covered lives?
A. Yes. Our plan uses one of the IRS-approved methods to determine the number of covered lives.
B. Our plan calculates this number, but I’m not sure which method we use.
C. I’m not familiar with these calculations.
4. Do you know the current PCORI fee for your plan year?
A. Yes. The fee is $3.84 for plan years ending on or after Oct. 1, 2025, and before Oct. 1, 2026. To determine fees for future July 31 deadlines, I will consult with my benefits adviser or check the IRS website.
B. I don’t know it offhand, but I think I can find someone who does.
C. I didn’t know that the rate could change from year to year.
5. Do you know which IRS form to file, and when?
A. Yes. We file Form 720 by July 31 each year.
B. I’m pretty sure our plan sponsor handles this.
C. An IRS form and a deadline are new to me.
6. Do you document and keep records of your PCORI fee calculations and filings?
A. Yes. I maintain records in case of a random or targeted audit.
B. I have some documentation, but it’s not organized or shared with colleagues.
C. I’m not aware of past or present documentation for the PCORI fee.
7. Do you coordinate with your plan sponsor or benefits adviser on PCORI compliance?
A. Yes. Roles and responsibilities are clearly defined.
B. I feel pretty confident they are handling PCORI compliance for our plan.
C. It hasn’t been discussed.
Understanding your score
Mostly A’s. If you scored mostly A’s, you are a PCORI pro. These answers reflect solid preparation and understanding of PCORI compliance. Keep up the good work, and consider sharing your processes with internal colleagues and industry contacts.
Mostly B’s. If you scored mostly B’s, consider working more closely with your benefits adviser. These answers show you’re on the right track, but some gaps in knowledge could lead to improper documentation, incorrect filings or missed deadlines.
Mostly C’s. If you scored mostly C’s, it’s urgent to implement better processes. Identify your plan type, review IRS guidance and set up a compliance calendar.
PCORI compliance requires organized processes and attention to detail. For more information, talk to your benefits adviser. They can explain the when, what and why behind the PCORI fee. They can also help you review Form 720, payment calculations and deadlines, and internal processes to ensure PCORI compliance.
