Out of Pocket Maximum Limits on Health Plans Delayed until 2015

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The Obama administration has delayed implementation of the out of pocket maximum for health insurance plans until 2015.  This consumer protection provision limited consumer’s out of pocket expenses to $6,350 for single coverage.  Now, health insurers that use more more than one service provider to administer benefits receive transitional relief in 2014.   Plans with multiple providers can continue separate out of pocket maximums for medical and drug benefits, and drug plans that do not have an out of pocket maximum currently will not have to impose one until 2015.

The Department of Labor (DOL) published the delay as an answer to one of 137 FAQs in February, but it wasn’t noticed until Monday, August 12 when the DOL confirmed the delay.  Health insurers have separate computer systems that administer medical and drug coverage, the DOL cited the difficulty connecting these computer systems as the reason for the delay.