Cost-Sharing Limits


Purpose:

To minimize the out-of-pocket expenses an individual can incur for all covered services under a health plan during the year


Intent:

To make more health coverage available to a covered individual


Related Provision:

Maximum Deductible Limit


Health Plans Affected by this Provision:


Year Effective: 2014
Medical Plan: Yes, unless plan is Grandfathered, a plan in effect and without significantly changed coverage or premium share since March 23, 2010
Dental/Vision Plan: No, if stand-alone benefit excepted from HIPAA’s portability provisions
HRA: No, if stand-alone benefit excepted from HIPAA’s portability provisions
Health Care FSA: Not applicable

Document Downloads:


Document Title Last Updated
Cost-Sharing Limits Flyer
01/06/2017
Final HHS Notice of Benefit and Payment Parameters for 2018 Fact Sheet 12/16/2016
DOL FAQ, January 9, 2014 01/09/2014
PHSA Essential Health Benefits  
2014 HDHP-HSA Limits, Revenue Procedure 2013-25  
Location (map)
1350 Deming Way, Ste 300
Middleton, WI 53562-4640

Mail Address
PO Box 44347
Madison, WI 53744-4347