2020 ACA Out-Of-Pocket Maximums and Health Savings Account Limits

As the Hays Research and Compliance team looks towards the new year, we want to inform our clients that there will be two plan design changes to consider for 2020:

  1. Affordable Care Act out-of-pocket maximum dollar limits, and,
  2. High Deductible Health Plan limits.

Affordable Care Act Out-Of-Pocket Maximum Dollar Limits

This April, the U.S. Department of Health and Human Services (HHS) released the 2020 HHS Notice of Benefit and Payment Parameters. For plan years beginning in 2020, the annual cost sharing limitation for non-grandfathered essential health benefits will be $8,150 for employee only (self) coverage, and $16,300 for other than employee only (family) coverage.

I. 2020 ACA Maximum Out-Of-Pocket Expenses (non-grandfathered plans)

  • $8,150 for self-only coverage
  • $16,300 for family coverage

II. 2020 HSA & HDHP Design Maximums

Catch-up contribution (Age 55 and older by the end of the tax year) $1,000


Action Steps

Because the cost-sharing limits for HDHPs (minimum deductible and maximum out-of-pocket) will change for 2020, employers that sponsor these plans may need to make plan design changes for plan years beginning in 2020. Also, if an employer communicates the HSA contribution limits to employees as part of the enrollment process, these enrollment materials should be updated to reflect the increased limits that apply for 2020.

NOTE: DOL, HHS and IRS guidance requires group health plans to embed an individual out-of-pocket maximum in the plan’s family coverage when the family out-of-pocket maximum exceeds the ACA’s out-of-pocket maximum for self-only coverage.

If you have any questions, please connect with your local Hays Consultant or contact us today.