Cost-Sharing Limits for Health Plans

In 2014, the ACA required certain health plans to comply with cost-sharing limits with respect to essential health benefits coverage. The cost-sharing limits included both an annual out-of-pocket maximum and annual deductible limit. On April 1, 2014, the annual deductible limit was repealed, effective as of the date the ACA was enacted. HCR Cost-sharing Limits for Health Plans provides an overview of the ACA’s cost-sharing limits and has been updated for the final out-of-pocket maximum for 2017.

ACA Mandates:  Different Measures of Affordability

Several key ACA reforms measure the affordability of employer-sponsored health coverage. Affordability of an employer’s health plan may be assessed for the employer shared responsibility penalty for large employers, the individual mandate and the premium tax credit for low-income individuals to purchase health coverage through an Exchange. Updated ACA Mandates – Different Measures of Affordability  provides a summary of these different measures of affordability and has been updated for indexed contribution percentages for 2017.

Please contact your Stellar representative with further questions regarding these notifications.