Deductible Limits
For plan years beginning on or after January 1, 2014, non-grandfathered insured, small group plans may not impose deductibles higher than $2,000 for individual coverage or $4,000 for family coverage (indexed for inflation based on health insurance premiums).
Note: The limit on deductibles only applies to certain types of health plans, such as major medical insurance. It does not apply to HIPAA excepted benefits, such as disability, cancer, hospital indemnity, or accident insurance. Click here for more information about the types of benefits that are exempt from the Health Care Reform plan design mandates.
Deductible Limits Hot Topics & FAQs
- Will higher deductibles be available for group plans offered through the state Health Insurance Exchanges?
Answer: No, group plans offered through the Exchanges will also have to comply with these deductible limits.
- May an employee purchase an individual insurance policy with a higher deductible?
Answer: Yes. The restriction on deductibles does not limit the deductibles an insurer may offer on an individual health insurance policy.
American Fidelity Assurance Company does not provide tax or legal advice.
