Beginning in 2014, all health plans (not just high-deductible health plans) were required to have an annual out-of-pocket limit that met HHS’s threshold for the year. HHS recently issued guidance on the maximum annual limitation on cost sharing for 2018. The increase from 2017 ($7,150 for individual coverage and $14,300 for family coverage) is a product of the dollar limit for calendar year 2014 and the premium adjustment percentage for 2018, rounded down to the nearest $50. The result for 2018 is annual limits on cost sharing of $7,350 for individual coverage and $14,700 for family coverage.
In a previous blog post, we provided the increased annual out-of-pocket maximums for HSA compatible high-deductible health plans ($6,550 for individual coverage and $13,100 for family coverage). High-deductible health plans are subject to both the HHS and IRS limits, and must follow whichever limits are more restrictive (i.e., high-deductible health plans must establish out-of-pocket maximums which comply with the lower IRS limits).