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

Posted on: October 10, 2019 By:

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

Posted on: November 17, 2015 By:

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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