If you’re responsible for employee benefits, it can feel like there’s always another deadline or acronym to keep track of—and it’s completely understandable to want clarity before you file. The Patient-Centered Outcomes Research Institute (PCORI) fee is one of those items that’s easy to overlook until it suddenly becomes urgent.
Below is a straightforward overview of what the PCORI fee is, who pays it, and what the 2026 filing generally involves.
What is the PCORI fee?
Also called the Comparative Effectiveness Research Fee (CERF), the PCORI fee helps fund the Patient-Centered Outcomes Research Institute under the Affordable Care Act. The IRS defines it as a fee on:
- Issuers of specified health insurance policies, and
- Plan sponsors of applicable self-insured health plans
PCORI is currently imposed through 2029.
Who pays the PCORI fee?
Responsibility depends on how your health plan is funded:
- Fully insured plans: The insurance carrier pays the IRS, and the cost is typically reflected in premiums. In most cases, employers with fully insured plans can essentially “ignore” the filing requirement, because the carrier is the one handling the PCORI fee reporting and payment.
- Self-funded or level-funded plans: The employer/plan sponsor pays the fee directly to the IRS.
- HRAs (Health Reimbursement Arrangements): Employers generally pay the PCORI fee for HRAs. However, if an HRA is structured so participants can opt out (a “limited” HRA in that sense), it may no longer be subject to the fee. If the HRA requires enrollment (for example, automatic enrollment with the medical plan), the fee typically applies.
- FSAs (Flexible Spending Accounts): FSAs are generally exempt if (1) the employer offers health insurance and (2) the employer contribution does not exceed the employee contribution.
Because a PCORI fee overpayment generally doesn’t carry over into the following year, calculating accurately matters.
How much is the fee for the 2026 filing?
The PCORI fee is calculated as a per covered life amount multiplied by the average number of lives covered under the plan.
For plan years ending on or after October 1, 2024 and before October 1, 2025, the fee is $3.47 per covered life.
For the filing due July 31, 2026, the fee depends on when your plan year ends:
- Plan years ending Jan 1, 2025 – Sept 30, 2025:$3.47 per covered life
- Plan years ending Oct 1, 2025 – Dec 31, 2025:$3.84 per covered life
When and how do you file?
PCORI fees are reported on IRS Form 720 (Quarterly Federal Excise Tax Return)—but most organizations file it once per year for PCORI.
- Due date:July 31 of the year following the last day of the plan/policy year
- Important:Form 720 and payment are due the same day
- Payments: There is an electronic filing option through the IRS, and no deposit is necessary for payment.
A simple next-step checklist
- Confirm whether your plan is fully insured vs. self/level-funded
- Identify any HRA or FSA arrangements that may affect responsibility
- Verify your plan year-end date to confirm the correct rate
- Coordinate with your TPA, carrier, payroll vendor, or tax professional on covered-life counts and filing logistics
If you’d like a steady partner in this process, Retek Benefit Solutions is here to support you—helping you ask the right questions, gather what’s needed, and stay on track so you can feel confident you’re doing your best to remain compliant.
And because every organization’s tax situation is a little different, we also recommend reaching out to your accountant to review the details and help ensure you file accurately and on time.