A non-grandfathered group health plan’s in-network out-of-pocket maximum for essential health benefits (EHBs) for the 2024 plan year cannot exceed $9,450 for self-only coverage and $18,900 for other-than self-only coverage.
The in-network out-of-pocket maximum applies to all individuals, regardless of whether an individual has a self-only plan or other-than single coverage. Self-funded group health plans are not required to cover EHBs. But, if they do, they cannot impose lifetime or annual dollar limits on those benefits.
For high-deductible health plans (HDHPs) for the 2024 plan year, the out-of-pocket limit will be $8,050 for self-only coverage ($550 more than for 2023) and $16,100 for other-than self-only coverage ($1,100 more than for 2023). The minimum deductible is changing to $1,600 for self-only coverage and $3,200 for other-than self-only coverage.
Regulatory Updates 