Regulatory Resources
The U.S. Department of Health and Human Services (HHS) has set the 2019 in-network out-of-pocket maximum for Essential Health Benefits for group health plans at $7,900 for self-only coverage and $15,800 for other-than-single coverage, an increase of 7 percent from 2018.
The 2018 maximum annual limitation on cost-sharing is $7,350 for self-only coverage and $14,700 for other-than-single coverage.
HHS announced the new out-of-pocket maximums in the 2019 Notice of Benefit and Payment Parameters final rule, which was released on April 9, 2018. The cost-sharing limitations apply to nongrandfathered plans.
For more information on cost sharing, follow this link.