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HHS Waives Annual Cap Rules in Certain Circumstances

November 1, 2010

The Department of Health and Human Services (HHS) has allowed 30 companies to continue offering certain insurance plans for the next year without being subject to the restriction on annual caps.  These health plans, generally known as “limited benefit” plans or “mini med” plans, offer less coverage and often have annual limits well below what the new health reform rules allow. Typically, companies offer this lower-cost coverage to part-time workers, seasonal workers and volunteers who otherwise may not be able to afford coverage at all.  Insurers and unions offering private health plans worried that the new rules would make it impossible to keep these plans affordable. 

HHS issued the waivers in order to ensure that individuals with this type of coverage would not be denied access to needed services or experience more than a minimal impact on premiums.  The waiver allows the company to avoid raising annual limits to $750,000 for plan years beginning between September 23, 2010, and September 22, 2011.  This is a one-year waiver, but can be renewed each year until the Health Benefit Exchanges become operational in 2014.  Click here for a list of companies receiving the waiver.