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Distribution of Out-of-Pocket Maximums for Family Coverage by Plan Type in 2012

This exhibit presents the distribution of out-of-pocket maximums among covered workers with a family aggregate limit for healthcare expenses in 2012. It highlights significant differences between various health plan types and indicates that HSA-qualified High Deductible Health Plans (HDHPs) have legally mandated maximums of $12,100 for family coverage. The data is sourced from the Kaiser/HRET Survey of Employer-Sponsored Health Benefits and reflects the out-of-pocket spending limits applicable either collectively or on a per person basis within a family.

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Distribution of Out-of-Pocket Maximums for Family Coverage by Plan Type in 2012

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  1. Exhibit 7.33Among Covered Workers with an Aggregate Out-of-Pocket Maximum for Family Coverage, Distribution of Out-of-Pocket Maximums, by Plan Type, 2012 * Distribution is statistically different from All Plans distribution (p<.05). NOTE: Distributions are among covered workers facing a specified limit for out of pocket maximum amounts. HSA-qualified HDHPs are required by law to have an out-of-pocket maximum of no more than $6,050 for single coverage and $12,100 for family coverage in 2012. The survey distinguished between plans that have a family aggregate out-of-pocket maximum that applies to spending by any covered person in the family or a separate per person out-of-pocket maximum that applies to spending by each family member or a limited number of family members. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2012.

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