Annual Benefit Limits Waiver Deadline

September 13, 2012

The Centers for Medicare & Medicaid Services (CMS) issued guidance for health care plans seeking to renew waivers on annual benefits. For plan years starting between September 23, 2010 and September 22, 2011, plans could not limit annual coverage of essential benefits such as hospital, physician and pharmacy benefits to less than $750,000. The restricted annual limit will be $2 million for plan years starting between September 23, 2012 and January 1, 2014. For plans issued or renewed beginning January 1, 2014, all annual dollar limits on coverage of essential health benefits will be prohibited.