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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


HSA-Compatible Health Plans in the Exchange

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Question: Hi, I recently heard that HSA-compatible health care plans are being excluded from the individual exchanges. Given that so many people purchasing individual plans choose high deductible plans, this seems strange that HSA-qualified plans would be excluded. Is this true, and if so, why would HSA-compatible plans be excluded given that consumer directed health care seems to be the way the country is moving (albeit slowly). Thanks for your response.

Answer: In 2014, the small group market, both inside the Exchange an in the private market, will have deductible limits that will negatively impact the HSA-qualified plan market. The cost-sharing limitation on maximum deductible, which applies for the small group market, limits the maximum deductible for the individual coverage is $2,000, and family plans it is $4,000, so HSAs will probably continue to be available, but their tax advantages will be impacted..

The essential benefit plan has yet to be defined by the HHS, but so far it looks like HSA qualified plans will be available in the individual Exchange. The individual market will have a limitation on the overall out-of-pocket maximum limit. This applies to deductibles, co-insurance, co-payments, or similar charges, as well as other expenditures that are qualified medical expenses. The cost sharing for these out-of-pocket expenses cannot exceed the maximum out-of-pocket expense limits for self-only and family coverage for HSA-compatible high deductible health plans during each taxable year. If we applied today’s corresponding limits, the out-of-pocket maximum for self-only coverage would be $5,950, and $11,900 for family coverage. These limits increase annually according to a “premium adjustment percentage” for the calendar year as determined by HHS. The fact that the ACA specifically mentions HSA-compatible high deductible health plans indicates that they will be in the mix.

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