Annual Limits under PPACA

[Chaz]

PPACA limits the ability of plans to have annual limits on essential health benefits. Is that calculated on an aggregate basis (so, as long as plan doesn't exceed the annual limit for all essential health benefits, it is okay) or is it applied on a benefit-by benefit basis (so, for instance, a plan can't have a $xxx annual limit on occupational therapy, assuming OT is an essential health benefit)?

I haven't seen this discussed anywhere.

[Chaz]

PPACA limits the ability of plans to have annual limits on essential health benefits. Is that calculated on an aggregate basis (so, as long as plan doesn't exceed the annual limit for all essential health benefits, it is okay) or is it applied on a benefit-by benefit basis (so, for instance, a plan can't have a $xxx annual limit on occupational therapy, assuming OT is an essential health benefit)?

I haven't seen this discussed anywhere.

Does anyone have any insight on this?

[Chaz]

Bueller? Bueller?

[GMK]

Just an opinion, based on very little research -

I think it's no limits on any essential health benefits. So, you can't put a limit OT services that qualify as essential health benefits. I would think that you could put a limit on OT services that do not qualify as essential benefits, if any. (As I said, very little research.)

[Chaz]

Thanks for the response. That's what I was thinking too but there are SO many plans out there with multiple limits on individual benefits.