2022 Maximum Out-of-Pocket Limits Finalized
May 9, 2021
The Department of Health and Human Services (HHS) finalized an $8,700 out-of-pocket maximum for self-only coverage and $17,400 for family coverage for health plans beginning in 2022. This is part of the Notice of Benefit and Payment Parameters for 2022 published on May 5, 2021.
The Affordable Care Act (ACA) requires non-grandfathered health plans to comply with an overall annual limit on out-of-pocket expenses for essential health benefits. The current limits, for 2021 plan years, is $8,550 for self-only coverage and $17,100 for family coverage.
The IRS has yet to release information on what the 2022 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.
The rule also finalizes a policy to codify that individuals with COBRA coverage may qualify for a special enrollment period to enroll in individual health insurance coverage on- or off-exchange based on the cessation of employer contributions or government subsidies (such as those provided for under the American Rescue Plan Act of 2021) to COBRA continuation coverage.
Reach out to your Hylant representative for further information. Don’t have one? Contact us here.
The above information does not constitute advice. Always contact your employee benefits broker or trusted adviser for insurance-related questions.