The PCORI Fee (Patient-Centered Outcomes Research Institute Fee) is a fee established under the Affordable Care Act (ACA). It helps fund research that evaluates the effectiveness, outcomes, and risks of various medical treatments and services. This fee is applicable to:
Issuers of specified health insurance policies
Sponsors of applicable self-insured health plans
Below are the six most important things you need to know about the PCORI Fee in 2025:
1.Due Date for 2025The PCORI Fee applies to policy or plan years ending on or after October 1, 2012, and before October 1, 2029.
Filing Form: IRS Form 720
Due Date: July 31, 2025
As per IRS Notice 2024-83, the PCORI Fee for plan years ending between October 1, 2024, and September 30, 2025, is $3.47 per covered life
This is an increase from the previous rate of $3.22. To understand how this fee has evolved since 2013, refer to our detailed PCORI Fee guide.The fee is calculated based on the average number of lives covered under the plan during the year. The IRS permits three methods for this calculation:
Actual Count Method: Count the total lives covered on each day of the plan year and divide by the number of days.
Snapshot Method: Choose a consistent date (or dates) each quarter and average the number of lives on those dates.
Form 5500 Method: Use participant counts from IRS Form 5500, if filed.
For Fully Insured Plans
The insurance provider (issuer) is responsible. This includes:
Major medical coverage plans
COBRA continuation coverage
Retiree medical coverage
Health Reimbursement Arrangements (HRAs) tied to insured plans
For Self-Insured Plans
The employer or plan sponsor must pay the fee. This includes HRAs offered on a stand-alone basis.
Entities that may owe PCORI Fees include:
Corporations
Government bodies
Non-profit organizations
Unions and associations with self-insured health plans
Failing to file or pay the PCORI Fee by the deadline can lead to penalties:
Late Penalty: 5% of the tax due per month, up to a maximum of 25%
Certain health plans are exempt from the PCORI Fee, including:
Excepted Benefits: Stand-alone dental or vision plans
Stop-Loss or Indemnity Insurance
Government Military Plans: e.g., TRICARE
International Employee Plans: Plans covering only employees who live and work outside the U.S.
Summary Table
Filing the PCORI Fee using Simple720.com is Straightforward
You can complete your PCORI Fee filing in minutes using the IRS-authorized platform Simple720.com. Here’s how:
Create an account or log in to your existing profile
Enter your business details and choose the second quarter
Select your policy type and enter the average number of covered lives
Review the calculated fee (automatically computed by the platform)
WRAP:
Filing the PCORI Fee accurately and on time is essential to avoid penalties and stay compliant with IRS regulations. With the 2025 due date approaching, now is the time to review your plan details and choose the right calculation method. Whether you're an insurer or self-insured employer, understanding your responsibilities is key. Simplify the process by filing your PCORI Fee Online through an authorized platform like Simple720.com.