Does out-of-pocket delay actually apply to you?

Published Updated 4 Min Read

Yet another Affordable Care Act delay is in the spotlight: limits on out-of-pocket spending.

According to the law, starting in 2014, health plan participants will be spending no more than $6,350 in total out-of-pocket costs for individuals and $12,700 for family plans. That cap on out-of-pocket spending has been delayed until 2015, however, if an employer is using two separate vendors for its medical and pharmacy benefits. Sandy Ageloff, southwest health & group benefits leader for Towers Watson, says the rule only applies “to nongrandfathered plans” and emphasizes that the delay only applies to those who split their services.

Tristan Lejeune
Associate Editor of Employee Benefit News

Associate Editor of Employee Benefit News


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