The Affordable Care Act: Processes Have Been Implemented to Administer the Patient-Centered Outcomes Research Fee, but Controls Need Improvement to Ensure Filing Compliance

The Commissioner, Small Business/Self-Employed Division should collaborate with the NAIC to obtain the lives covered field and ensure that databases obtained from the DOL include Form 5500 and Form 5500-SF, along with attached Schedule A, Schedule H, and/or Schedule I, for health care benefits plans. Analyze this information to identify potential Form 720 PCOR fee nonfilers.

The Commissioner, Small Business/Self-Employed Division should based on the NAIC and DOL database analysis results, identify a population of Form 720 PCOR fee nonfilers to send notices. Based on the response to these notices, determine if additional enforcement actions are required for these potential Form 720 nonfilers.

The Commissioner, Wage and Investment Division should issue alerts during the third quarter of each fiscal year to remind Submission Processing function employees, when processing the Form 720 with a PCOR fee, to use caution when transcribing the average number of lives covered to avoid inadvertently recording the digits after decimal places.

The Commissioner, Wage and Investment Division should establish a systemic error reporting process for Forms 720 with a PCOR fee to identify any accounts in which the transcribed average number of lives covered, the PCOR fee and/or tax payments do not match. If any of the amounts do not match, refer these accounts for further analysis (and examination if appropriate).