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2020 Maximum Out-of-Pocket Limits Announced

Apr 22, 2019 Decorative image: health insurance form

Last Friday, the Department of Health and Human Services (HHS) released the 2020 maximum out-of-pocket limits for non-grandfathered plans. The 2020 maximum for individuals with self-only coverage is $8,150, and the maximum for those enrolled in family coverage is $16,300. The current 2019 maximums are $7,900 for self-only coverage and $15,800 for family coverage. It is important to note that these limits apply to all non-grandfathered group health plans under the Affordable Care Act (ACA) and are effective for plan years beginning on or after January 1, 2020.

Next month, the IRS is expected to release information on what the 2020 requirements will be for high deductible health plans (HDHPs) and health savings accounts (HSAs). The HDHP/HSA requirements include a minimum deductible, a maximum out-of-pocket limit and a maximum HSA contribution amount. These requirements apply to both grandfathered and non-grandfathered group health plans.

Therefore, employers who offer HDHP/HSA plans that are not grandfathered are subject to both sets of requirements and need to comply with the lesser out-of-pocket maximums, expected to be announced next month.

The above information does not constitute advice. Always contact your employee benefits broker or trusted adviser for insurance-related questions.

Author Holly Wahl, Hylant Vice President, Employee Benefits Compliance Leader

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