Limits on health plan out-of-pocket (OOP) maximums for 2017 have been announced by the Department of Health and Human Services.  Annual limits on OOP maximums are imposed by the Affordable Care Act (ACA) as the maximum amount an enrollee in a non-grandfathered health plan could be expected to pay for covered essential health benefits through cost-sharing (carriers can choose to establish lower limits for certain plans).  

The limits apply to both self-insured as well as large-group health plans.  The OOP maximum includes the yearly deductible and any cost-sharing obligations enrollees have, such as coinsurance, once the deductible is met.  The OOP maximum does not include premiums, billing amounts for out-of-network cost-sharing or spending for nonessential health benefits.  The limits below on OOP Maximums also do not apply to grandfathered or retiree-only plans.

Please note that the limits OOP Maximums for High Deductible Health Plans (HDHP) plans are different.  The limit on OOP Maximums in 2016 for HDHP plans compatible with a Health Savings Account was $6,550 for single coverage and $13,100 for family coverage.