Out-of-pocket maximum for group health plans announced for 2024
OOPM released for 2024 plan year represents 3.9% increase from OOPM for 2023 plan year.
- All states
- Regulatory and compliance
The out-of-pocket max (OOPM) for 2024 is $9,450 for self-only coverage and $18,900 for other than self-only coverage. OOPM applies to most fully insured and self-funded non-grandfathered group health plans. It does not apply to grandfathered, transitional Relief and retiree-only plans.
The final 2024 out-of-pocket maximum (OOPM) for group health plans is outlined below:
|OOPM for 2024 plan year||OOPM for 2023 plan year|
|Self-only: $9,450||Self-only: $9,100|
|Family: $18,900||Family: $18,200|
The 2024 OOPM represents an approximately 3.9% increase above the 2023 parameters of $9,100 for self-only coverage and $18,200 for other than self-only coverage.
The annual OOPM requirement applies to most non-grandfathered group health plans, regardless of whether the plan is fully insured or self-funded (ASO). It does not apply to grandfathered, transitional Relief and retiree-only plans. The OOPM includes copayments, deductibles, and coinsurance amounts associated with both medical and pharmacy covered benefits.
High-deductible plans with health savings accounts (HSAs) have limits that are different, including OOPM, deductible and contribution limits. UnitedHealthcare is still awaiting Internal Revenue Service (IRS) final rules for 2024 HSA limits historically released in May and will communicate the information once available.
For questions, please contact your broker or UnitedHealthcare representative.
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