Reminder: Medical and Rx Out-of-Pocket Expenses Combined Total Cost Share Now in Effect

Effective January 1, 2015, out-of-pocket expense limits for medical and prescription drug benefits covered by all NRECA medical plans were combined into a single total cost share amount, as required by the Affordable Care Act (ACA). Previously, only high deductible health plans had a combined total cost share amount. The total cost share amount consists of the plan’s deductible and annual out-of-pocket coinsurance maximum amounts. All copays and coinsurances accumulate toward the total out-of-pocket coinsurance maximum amount. Once the current year’s total cost share amount is reached, the plan begins to pay eligible benefits at 100%.

For 2015, the combined total cost share limit for medical and prescription drug coverage cannot exceed $6,600 for individuals and $13,200 for families, as specified by the ACA.

If you have questions, contact your field representative. You also can contact the Member Contact Center at 866.673.2299 or contactcenter@nreca.coop.