2015 Cost Sharing Limits

The Department of Health and Human Services (HHS) released the final Notice of Benefit and Payment Parameters for 2015. This final rule included the finalized out-of-pocket maximum limits on cost sharing, maximum deductible limitations, and the national annual limit on cost sharing for stand-alone dental plans (SADPs) for the pediatric dental essential health benefit (EHB) for 2015.

For 2015, the out of pocket maximum on cost sharing is:

  • $6,600 for self-only coverage (up from $6,350 in 2014)
  • $13,200 for coverage other than self-only (up from $12,700 in 2014)

For 2015, the national annual limits on cost sharing for stand-alone dental plans covering pediatric dental (as an essential health benefit) offered through the Marketplace are:

  • $350 for one covered child (reduced from $700 for 2014), and
  • $700 for two or more covered children (reduced from $1,400 for 2014)

The final 2015 out-of-pocket maximum limits for health savings account (HSA) compatible high deductible health plans are expected to be released by the Internal Revenue Service in mid-2015.

Fact sheet: HHS 2015 Health Policy Standards Fact Sheet

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The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.