PCORI fee and Form 5500 due July 31, 2026: what DC, Maryland, and Virginia employers need to know
Key takeaways
- Both the PCORI fee and the calendar-year Form 5500 are due July 31, 2026 for affected DC, Maryland, and Virginia employers.
- The 2026 PCORI rate is $3.47 per covered life for plan years ending January through September 2025, and $3.84 for those ending October through December 2025.
- Form 5500 is an annual ERISA report filed electronically through EFAST2; Form 5558 can extend the deadline.
- Missing these deadlines can trigger penalties, so confirm your plan’s end date and covered-lives count now.
The July 31, 2026 deadline for the PCORI fee and Form 5500 is approaching fast. If your company offers a self-funded, level-funded, or HRA health plan, you might still be wondering who must file and pay the PCORI fee. This common confusion can lead to missed deadlines and penalties. In this post, you’ll find clear guidance on PCORI fee 2026 responsibilities, how to calculate fees using the 2025 plan year rates, and what you need to know about Form 5500 deadlines and extensions.
PCORI Fee 2026: Key Details
As we edge nearer to the deadline, understanding the specifics of the PCORI fee for 2026 is crucial. This section breaks down who pays the fee and how to calculate it.
Who Pays PCORI Fee?
Employers with self-funded, level-funded, or HRA health plans are responsible for filing and paying the PCORI fee. If your plan is fully insured, the carrier handles the filing. But if you’re managing a level-funded or HRA plan, the employer must submit the fee. It’s a common trap to assume the carrier will handle it, which can lead to penalties.
Calculating the PCORI Fee 2026
Calculating your fee involves multiplying the average number of covered lives by the applicable rate. For 2026 filings, use the 2025 rates. Plans ending between January and September 2025 use a rate of $3.47 per covered life, while those ending between October and December 2025 use $3.84. Accurate calculation helps prevent unexpected fees.
PCORI Rates for 2025 Plan Year
Understanding the rates helps you prepare. For the 2025 plan year, two different rates apply. The rate of $3.47 applies to plans ending from January to September, and $3.84 for those ending from October to December. Be sure to apply the correct rate based on your plan’s end date.
Understanding Form 5500 Deadlines
Navigating Form 5500 deadlines can be challenging. This section aims to clarify due dates and the extension process, ensuring you stay compliant.
Calendar Year Form 5500 Due Date
Form 5500 is an annual ERISA report that must be filed electronically. For calendar-year plans, the due date is July 31 each year. Missing this date can result in costly penalties, so mark your calendar to avoid surprises.
Utilizing Form 5558 Extension
If you need more time, Form 5558 offers a 2.5-month extension, moving the due date to October 15. This extension must be filed before the original deadline. It’s a valuable option if more time is required to gather necessary documentation.
EFAST2 Filing with DOL
Filing via the EFAST2 system with the Department of Labor is mandatory for Form 5500. Ensure your filings are accurate and submitted on time. This electronic system simplifies the process, but it’s crucial to understand its workings to avoid errors.
Frequently Asked Questions
What is the PCORI Fee 2026?
The PCORI fee is charged to health plans to fund research on patient-centered outcomes. It applies to most self-funded, level-funded, and HRA plans. For 2026, employers must calculate and pay using 2025 rates, ensuring compliance with the IRS.
Who Files Form 5500?
Form 5500 is filed by plan administrators of employer-sponsored retirement and health plans. This form provides the government with information about the plan’s financial condition and operations. It’s an essential part of ERISA compliance.
How Do I Calculate Average Covered Lives?
Calculating average covered lives can be done using several methods, such as the actual count method, snapshot method, or Form 5500 method. Each has unique steps, so choose the one that best fits your plan’s structure.
Understanding these requirements and deadlines can prevent costly penalties, ensuring your compliance. Remember, this information serves as general education and not as specific tax or legal advice.
Related reading from Capitol Benefits
Ready when you are
Let's take a look at what you've got.
A real review of your current coverage. No deck, no pressure, and usually some money saved along the way.