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Anthem Blue Cross and Blue Shield

Jun 15, 2022

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PCORI fees increasing for 2022 payment

The annual mandated fee to fund the Patient-Centered Outcomes Research Institute (PCORI) is increasing to $2.79 per member, up from $2.66 last year. It’s mandated by the Affordable Care Act and due August 1, 2022.

Fees are paid annually with the submission of IRS Form 720. We pay it for fully insured employers. Self-insured clients pay it directly to the IRS. Small Group Anthem Balanced Funding (ABF) and Multiple Employer Welfare Arrangement (MEWA) clients may need your guidance on calculating and paying the fees.

The fees can be calculated by:

  • The actual count method. Total lives covered each day of the year, divided by the number of days in the plan year.
  • The snapshot method. Total lives covered on one date in each quarter of the plan year.
  • The snapshot factor method. Lives covered on any one day may be determined by counting the actual number of lives covered on that day or by treating those with self-only coverage as one life and those with coverage other than self-only as 2.35 lives.
  • The Form 5500 method. A formula that includes the number of participants reported on Form 5500 for the plan year.

Be ready to share this information with your clients who may need your assistance.

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