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July 18, 2014

HRB-93: Elimination of Deductible Limits in Small Employer Sponsored Plans (article)

Released April 4, 2015 I Download as a PDF

April 4, 2014 -- On April 1, 2014, President Obama signed H.R. 4302, Protecting Access to Medicare Act of 2014 (Public Law No 113-93).  Part of this so-called “doc-fix” law that temporarily adjusts the formula used to determine Medicare reimbursement payments to doctors includes a provision (Section 213) that repeals the ACA’s deductible restriction imposed on small employer plans, retroactive to the ACA’s enactment (March 23, 2010).  What this means is that small employer plans will no longer be subject to the $2,000 single/$4,000 family deductible restriction. 

These types of plans will continue to be subject to the out-of-pocket restrictions.  For 2014, the annual out-of-pocket limits applicable to both insured and self-funded plans offered through and outside the Marketplace are $6,350 for single coverage and $12,700 for coverage for more than one.  In 2015, the maximum annual limitation on cost sharing is $6,600 for self-only coverage; $13,200 for other than self-only coverage (see the Cost Sharing Limitation discussion in the HHS Benefit and Payment Parameters for 2015 section of this CBIZ Health Reform Bulletin).



About the Author:  Karen R. McLeese is Vice President of Employee Benefit Regulatory Affairs for CBIZ Benefits & Insurance Services, Inc., a division of CBIZ, Inc.  She serves as in-house counsel, with particular emphasis on monitoring and interpreting state and federal employee benefits law.  Ms. McLeese is based in the CBIZ Leawood, Kansas office.


The information contained herein is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations. The information contained herein is provided as general guidance and may be affected by changes in law or regulation. The information contained herein is not intended to replace or substitute for accounting or other professional advice. Attorneys or tax advisors must be consulted for assistance in specific situations. This information is provided as-is, with no warranties of any kind. CBIZ shall not be liable for any damages whatsoever in connection with its use and assumes no obligation to inform the reader of any changes in laws or other factors that could affect the information contained herein. As required by U.S. Treasury rules, we inform you that, unless expressly stated otherwise, any U.S. federal tax advice contained herein is not intended or written to be used, and cannot be used, by any person for the purpose of avoiding any penalties that may be imposed by the Internal Revenue Service.


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