The most important practical fact is that a foreign mutual fund or ETF is a PFIC. A US citizen who moves to London or Tokyo, opens a local brokerage account, and buys what looks like a perfectly normal index fund has almost certainly bought a PFIC, because a foreign pooled fund is a foreign corporation whose assets are overwhelmingly passive. The same US index exposure bought through a US-domiciled fund is not a PFIC. So the trap is not exotic; it is the default outcome of investing locally while remaining a US taxpayer, and avoiding it is largely a matter of holding US-domiciled funds.
The default regime, under section 1291, is punitive in a specific way. If the owner makes no election, tax is deferred while the shares are held but reckoned harshly when there is an "excess distribution" or a sale. An excess distribution, broadly a distribution larger than 125 percent of the average of the prior three years, and any gain on sale, are allocated ratably across every day of the holding period. The amount allocated to the current year is taxed normally, but the amount allocated to each earlier year is taxed at the highest ordinary income rate in effect for that year, regardless of the investor's actual bracket, and then charged interest as though the tax had been underpaid since that year. The result can approach or exceed the economic gain, and it strips out the preferential capital-gains rate entirely.
The two elections trade the punishment for current taxation. A qualified electing fund (QEF) election under section 1293 taxes the owner each year on a pro-rata share of the fund's ordinary earnings and net capital gain, whether or not distributed, and preserves the capital-gain character. It is usually the best outcome, but it requires the fund to provide a PFIC annual information statement, and most foreign funds do not, so the election is often unavailable in practice. A mark-to-market election under section 1296, available for PFIC stock that is regularly traded on a qualified exchange, taxes the annual increase in value as ordinary income each year and allows a limited ordinary loss for declines, but it does not preserve capital-gain character.
Reporting is annual and per fund. A US person who owns PFIC shares generally files Form 8621 for each PFIC each year, to make or maintain an election or to report an excess distribution or disposition. There are narrow reporting exceptions for small holdings, but the safest assumption is that each foreign fund is a separate annual form. The combination of harsh tax and per-fund paperwork is why cross-border advisors steer US clients firmly toward US-domiciled funds.