For all non-grandfathered health plans beginning in 2016, the maximum annual out-of-pocket limit is $6,850 for self-only coverage and $13,700 for other than self-only coverage.
HHS and DOL recently clarified that the self-only maximum annual out-of-pocket limits apply to each individual, regardless of whether the individual is enrolled in self-only coverage or in coverage other than self-only.
This change is expected to impact aggregate high deductible health plans for HSAs and other High Deductible Health Plans. Complying with this change, employers should anticipate an increase in premium as they move to the more expensive embedded deductible health plans.