For plans other than high deductible health plans (HDHPs) paired with HSAs, regulations issued by the Department of Health and Human Services in December 2016 set the following 2018 limits for the Maximum Out-of-Pocket (MOOP) for Essential Health Benefits (EHB) for non-grandfathered health plans:

MOOP (Maximum Out-of-Pocket) Limits

The following chart shows the 2018 limits set by the IRS in Rev. Proc. 2017-37 for health savings accounts (HSAs) and high-deductible health plans (HDHPs). As the chart reflects, all such limits increased from 2017.

HSA and HDHP Limits

Note the age 55-catch-up contribution limit for HSAs, which is not adjusted annually for inflation, remains unchanged at $1,000.

If you have any questions about these or other limits or about the impact on your plan, contact your Cheiron consultant.

Cheiron is an actuarial consulting firm that provides actuarial and consulting advice. However, we are neither attorneys nor accountants. Accordingly, we do not provide legal services or tax advice.

¹ Plans with family Out-Of-Pocket (OOP) limits must apply the self-only limit for each person enrolled in family coverage. This means that once a person covered under a family plan reaches the self-only OOP maximum, then all expenses above the self-only limit for covered essential health benefits (EHBs) for that person must be reimbursed at 100%, even if the family OOP maximum has not been met.

² The Health Savings Account (HSA) plan limits in this chart apply for individuals who also have coverage under a High Deductible Health Plan (HDHP) for the plan year.

³ These HDHP limits apply for individuals who also have coverage under a HSA for the plan year.