The Affordable Care Act (ACA) requires non-grandfathered plans to comply with an out-of-pocket maximum on essential health benefits (EHB). The out-of-pocket maximum is updated annually based on the percent increase in average premiums per person for health insurance coverage.

Under the Department of Health and Human Services’ (HHS) Notice of Benefit and Payment Parameters for 2022, the out-of-pocket maximum will increase for 2022 to:

  • $8,700 for self-only coverage ($150 increase)
  • $17,400 for family coverage ($300 increase)

In addition, High Deductible Health Plans (HDHP) linked to Health Savings Accounts (HSA) are subject to IRS rules for out-of-pocket expenses and other limits. See summary below for the 2022 adjusted annual limits for HSAs and affiliated HDHPs announced in Rev. Proc. 2021-25.

 

Annual HSA contribution maximums

  • $3,650 for an individual with self-only coverage under a HDHP ($50 increase)
  • $7,300 for an individual with family coverage under a HDHP ($100 increase)

 

Annual HDHP limits

  • Deductible no less than:
    • $1,400 for self-only coverage (no change)
    • $2,800 for family coverage (no change)
  • Out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) no more than:
    • $7,050 for self-only coverage ($50 increase)
    • $14,100 for family coverage ($100 increase)

 

Employers should consider these limits, if applicable, as they evaluate 2022 renewal options. Please see bulletin below for more information.

Read Our Bulletin

 

If you have questions or need help, please contact one of our benefit consultants.

See also  Compliance ✔- COBRA Subsidy Expiration Notice Due by Sept. 15 or Sooner