A complete step-by-step guide to paying the PCORI fee online for 2026, covering who must pay (fully insured vs self-insured vs HRA plans), the updated rates of $3.47 and $3.84 per covered life from IRS Notice 2025-61 with their specific Form 720 Line 133c and 133d references, the three IRS-approved covered lives calculation methods (Actual Count, Snapshot, Form 5500), a six-step payment workflow through eFileExcise720, a six-factor online vs paper comparison table, the July 31, 2026 deadline, failure-to-file and failure-to-pay penalties, and Form 8849 refund eligibility for overpayments.