Health Care Reform: Cost-Sharing Limits for Health Plans

Beginning in 2014 the ACA requires certain health plans to comply with cost-sharing limits with respect to essential health benefits coverage. The cost sharing limits include both an annual out-of-pocket maximum and anannual deductible limit.


 Call me for a copy of the Legislative Brief summarizing the ACA's cost sharing limits.


On April 1, 2014 President Obama signed into law the Protecting Access to Medicare Act which repels the ACA's deductible limit, effective as the date the ACA was enacted.


The affected plans are Grandfathered plans not subject to the ACA's cost-sharing limits.  There was some uncertainty regarding which types of non-grandfathered plans must comply with the cost-sharing limits.  However, the final rule provides the guidance on the types of health plans that must comply.