The Patient-Centered Outcomes Research Institute (PCORI) fee is a small annual federal fee imposed on self-insured health plans to fund comparative-effectiveness research. Florida small businesses with fully-insured group health plans don't file directly — the carrier handles it as part of premium. But businesses with self-funded plans, level-funded plans, or any HRA (including ICHRA, QSEHRA, EBHRA, and integrated HRAs) must file Form 720 each year and pay the fee directly. Missing the July 31 deadline triggers IRS interest and penalties.
The fee per covered life depends on the plan year ending date:
| Plan Year Ending | Fee per Covered Life |
|---|---|
| October 2024 – September 2025 | $3.47 |
| October 2025 – September 2026 | $3.47 (subject to annual adjustment) |
The fee adjusts annually based on the Federal Per Capita National Health Expenditures inflation factor. IRS publishes the new rate in spring of each year.
| Plan Type | Who Pays PCORI Fee |
|---|---|
| Fully insured group health | Carrier (employer not directly responsible) |
| Self-funded group health | Plan sponsor (employer) |
| Level-funded plan | Plan sponsor (employer) — even though it feels like fully insured |
| QSEHRA | Employer files |
| ICHRA | Employer files |
| Integrated HRA | Employer files (separate from carrier's filing on the underlying plan) |
| EBHRA (Excepted Benefit HRA) | Exempt — no PCORI fee |
| Retiree-only HRA | Exempt |
| Standalone dental/vision | Exempt |
The PCORI fee is reported on IRS Form 720 (Quarterly Federal Excise Tax Return), specifically Part II line 133. The annual fee is due by July 31 following the plan year end. A calendar-year plan that ended December 31, 2025 files by July 31, 2026.
Form 720 can be filed electronically (recommended) or by paper. Payment can be made via EFTPS or with the form.
Florida small businesses can use one of three counting methods:
For an HRA, "covered lives" = the participating employees only (NOT spouses or dependents). For a self-funded health plan, "covered lives" = all enrolled employees plus enrolled spouses and dependents.
| Item | Value |
|---|---|
| Average covered employees in plan year | 12 |
| Fee per covered life (2025-2026 plan year) | $3.47 |
| Total PCORI fee due | $41.64 |
| Form 720 deadline | July 31, 2026 |
If you have a fully-insured plan, the carrier files and pays — no Form 720 from you. If you have a level-funded plan, despite the carrier handling many other functions, the PCORI fee is YOUR responsibility. Read the plan documents carefully or ask the broker.
Late filing/payment incurs IRS interest plus a 5% per month failure-to-file penalty (capped at 25%) and 0.5% per month failure-to-pay penalty. For a small fee amount ($30-$200 typical for a small ICHRA), the late penalty often exceeds the fee. File on time.
No — PCORI applies only to plans providing 'specified health insurance' (medical care). Standalone dental, vision, accident, disability, AD&D, and excepted benefits like the EBHRA are exempt.
A licensed Florida broker can confirm whether your plan triggers Form 720 and help with the filing.
Get a Consultation