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Fees on Self-Insured Health Plans and Health Insurance Policies to Fund the PCORI
Sidley Austin LLP 
[Guidance Overview] Dec. 11, 2012 "There are situations, however, when the same individual must be taken into account more than once in calculating the fee. When the same individual is covered under a health insurance policy and a self-insured health plan, he or she is taken into account in calculating the amount of the fee payable both by the insurer and by the plan sponsor. For example, an individual is counted twice if he or she is covered by (i) a major medical insurance policy and a self-insured prescription drug program, or (ii) a group health insurance policy and an HRA." |
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