Must Drug Manufacturer Coupons Count Toward Annual Maximum Out-Of-Pocket Limits? Stay Tuned …

What is the Annual Maximum Out-Of-Pocket Limit (“MOOP”)?

MOOP is the most a participant must pay for covered services under a group health plan in a plan year. After a participant spends this amount on deductibles, copayments, and coinsurance, the health plan must pay 100% of the costs of covered benefits.

What are Drug Manufacturers’ Coupons (“Coupons”)?

Many drug manufacturers offer coupons to patients to reduce out-of-pocket costs. Drug manufacturers may offer these coupons for various reasons including: (1) to compete with another brand name drug in the same therapeutic class; (2) to compete with a generic equivalent when released; or (3) to assist consumers whose drug costs would otherwise be extremely high due to a rare or costly condition. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , ,

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IRS Announces 2016 Health FSA, HSA, HDHP and Transportation Plan Limits

The IRS has announced cost of living adjustments for health flexible spending accounts (“health FSAs”) in Section 125 cafeteria plans, contributions to health savings accounts (“HSAs”), out-of-pocket maximums under high deductible health plans (“HDHPs”) and qualified transportation plan benefits for 2016.

For 2016, the health FSA limit on voluntary employee salary reduction contributions will remain $2,550 (unchanged from 2015).  For 2016, the HSA contribution limit for individuals will remain $3,350 (unchanged from 2015).  For families the HSA contribution limit for 2016 is $6,750 (increased from the 2015 limit of $6,650).  For 2016, the HDHP out-of-pocket maximum for individuals is $6,550 (increased from the 2015 limit of $6,450).    Read More ›

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