About PCORI fee reporting

The Patient Centered Outcomes Research Initiative (PCORI) fee is imposed, as part of the ACA, on all issuers of certain health policies and on sponsors of applicable self-insured health plans. This includes your PeopleKeep health benefit because it’s a self-insured health plan.

As a plan sponsor, you need to report PCORI fees annually on IRS Form 720. The fee you’ll pay is based on the number of eligible employees in your benefit last year. This fee, and your completed Form 720, are due by 7/31/2018.


How to complete Form 720

Download the form here: IRS Form 720

In the examples below, the benefit covered an average of 3 eligible employees for their 2017 benefit year.


Step 1. Complete company information header

  • *Quarter ending will be June 30, 2018
  • ** Only check Final return if the company is 1) going out of business, or 2) will not be required to file a Form 720 in future quarters

Step 2. Complete Part II, line 133(d)*

  • *If your PeopleKeep benefit ended before October 1, 2017, you’ll complete line 133(c) instead. Your rate for average covered life will be $2.26 rather than $2.39.

Step 3. Complete Part III lines 3 and 10, sign and date

Step 4. Complete Payment Voucher

Step 5. Send completed form, payment voucher and check to:

Department of the Treasury

Internal Revenue Service

Cincinnati, OH 45999-0009

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