QUESTION

I thought there was a cap on out-of-pocket costs but my prescription drug benefit requires me to pay co-pays even after I’ve met the out-of-pocket limit for other medical benefits. Is that allowed?

Post enrollment issues | Employer-Sponsored Coverage
ANSWER

No, employer plans must ensure that each separately administered benefit has an out-of-pocket cap and the total of all caps combined cannot be more than $7,350 for an individual or $14,700 for a family in 2018. (81 Fed. Reg. 94058, Dec. 22, 2016).

Individuals with no coverage
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Post enrollment issues