Fully Insured and Self-Funded
Reform and Regulatory The Internal Revenue Service (IRS) recently announced the applicable dollar limits for group plans and high deductible health plans (HDHPs) / health savings accounts (HSAs) for the 2019 calendar year.
Below is an overview of the adjusted dollar limits for 2019. Self-only coverage refers to plans for one individual, while family coverage refers to plans for two or more individuals. The out-of- pocket maximum includes copayments, deductibles and coinsurance amounts, and excludes premiums.
Maximum out-of-pocket limit for 2019 group plans:
- $7,900 for self-only coverage ($7,350 in 2018)
- $15,800 for family coverage ($14,700 in 2018)
The annual out-of-pocket maximum requirement does not apply to transitional relief and retiree only plans.
2019 Limits for High Deductible Health Plans (HDHP) / Health Savings Accounts (HSA)
Minimum deductibles for 2019 (no change from 2018):
- $1,350 for self-only coverage
- $2,700 for family coverage
- $2,700 for embedded individual deductible
Compliant HSA plan examples:
- Embedded deductible. One plan for self-only and family have an embedded deductible, the minimum deductibles are: $2,700 individual and $2,700 family.
- Non-embedded deductible. One plan for self-only and family have a non-embedded deductible, the minimum deductibles are: $1,350 individual and $2,700 family.
Out-of-pocket maximum for 2019:
- $6,750 for self-only coverage (versus $6,650 in 2018)
- $13,500 for family coverage (versus $13,300 in 2018)
Watch for the intersection of the HSA and Affordable Care Act (ACA) rules. The 2019 ACA maximum is $7,900 for individual and $15,800 family (versus $7,350 individual and $14,700 family in 2018).
Compliant HSA/ACA plan examples:
- Embedded out-of-pocket max. One plan for self-only and family with an embedded out- of-pocket maximum, the maximum amounts are: $6,750 individual and $13,500 family
- Non-embedded out-of-pocket max. One plan for self-only and family with a non- embedded deductible, the maximum amounts are: $6,750 individual and $7,900 family
HSA contribution limits for 2019:
- $3,500 for self-only coverage (versus $3,450 in 2018)
- $7,000 for family coverage (versus $6,900 in 2018)
- The annual “catch-up” contribution amount for individuals age 55 or older will remain $1,000.
Contact your UnitedHealthcare representative or refer to the 2019 Health Savings Account Guidelines Overview flier for more information.