Reform Alert - News from the Blues' Office of National Health Reform

IRS provides guidance on 2015 High Deductible Health Plans Out-of-Pocket Maximum Limits

April 25, 2014

In the Affordable Care Act (ACA), the generally applicable out-of-pocket (OOP) maximum limits and OOP maximum limits for health savings account-compatible high deductible health plans (HDHPs) were the same in 2014.

However, beginning in 2015, there will be different amounts for the general OOP maximum and the OOP maximum limits specifically for HSA-compatible HDHPs. This is a result of the OOP maximum limits for HDHPs being governed by the indexing required in the Internal Revenue Code, while the indexing for general OOP maximum limits is determined by the Department of Health and Human Services.

On April 23, the IRS released the 2015 out-of-pocket (OOP) maximum limits for HSA-compatible high deductible health plans.

For 2015, the out-of-pocket maximum limits will be:

  • $6,450 for self only coverage (up from $6,350 in 2014)
  • $12,900 for coverage other than self-only (up from $12,700 in 2014)

Also included in this same guidance was the annual HDHP contribution limitations on deductions for 2015:

  • $3,350 for self only coverage
  • $6,650 for coverage other than self only

Finally, the annual minimum deductible for a HDHP must be at least $1,300 for self only or $2,600 for coverage other than self only in 2015.

As a reminder, the general OOP maximum limits for 2015 under the ACA was finalized on March 5 as $6,600 (for self only coverage) and $13,200 (for coverage other than self only).

Where can I find more information?
More information can be found at Revenue Procedure 2014-30.

The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.