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Second Circuit: HHS Rule for Embedded Individual Out-of-Pocket Limits Does Not Apply to Pre-2016 Health Insurance Plans
Roberts Disability Law Link to more items from this source
Apr. 26, 2022

"[A 2015 HHS rule states] that 'beginning in 2016, insurance providers cannot require any individual, including those with family coverage, to spend more than the individual out-of-pocket limit established under the Act -- a limitation commonly known as an "embedded individual out-of-pocket limit." ' The court found that the final rule adopted in 2015 for health insurance plans in 2016 does not apply retroactively for Fisher's claims under the 2014 and 2015 health insurance plans." [Fisher v. Aetna Life Ins. Co., No. 20-3148 (2d Cir. Apr. 22, 2022)]

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