The Affordable Care Act (ACA) calls for the creation of the "Patient-Centered Outcomes Research Institute" in order to help research clinical effectiveness in medical treatments and procedures.
Funding for this program comes from an annual fee—often referred to as the “PCORI fee”—imposed upon health insurers and many sponsors of self-insured plans. For policy or plan years ending on or after October 1, 2016 and before October 1, 2017, the fee is $2.26 multiplied by the number of covered individuals.
Please note, if your HRA is integrated with self-insured major medical coverage, then you only need to calculate the PCORI fee once for the two plans (in other words, you don’t have to pay twice for the two plans). If, however, your HRA is integrated with an insured major medical plan, then you have to calculate the fee for the HRA (your insurer will pay its PCORI fee for the major medical plan).