§ 3217-F — Prohibition on lifetime and annual limits

§ 3217-f. Prohibition on lifetime and annual limits. (a) An insurer\nshall not establish a lifetime limit on the dollar amount of essential\nhealth benefits in an individual, group or blanket policy of hospital,\nmedical, surgical or prescription drug expense insurance.\n (b) An insurer shall not establish an annual limit on the dollar\namount of essential health benefits in an individual, group or blanket\npolicy of hospital, medical, surgical or prescription drug expense\ninsurance for policy years beginning on and after January one, two\nthousand fourteen.\n (c) For policy years beginning prior to January one, two thousand\nfourteen, an insurer may establish restricted annual limits on the\ndollar amount of essential health benefits in an individual, group, or\nblanket policy of hospital, medical, surgical or prescription drug\nexpense insurance consistent with section 2711 of the Public Health\nService Act, 42 U.S.C. § 300gg-11 or any regulations thereunder.\n (d) The requirements of subsections (b) and (c) of this section shall\nnot be applicable to an individual policy that is a grandfathered health\nplan. For purposes of this section, "grandfathered health plan" means\ncoverage provided by an insurer in which an individual was enrolled on\nMarch twenty-third, two thousand ten for as long as the coverage\nmaintains grandfathered status in accordance with section 1251(e) of the\nAffordable Care Act, 42 U.S.C. § 18011(e).\n (e) For purposes of this section, "essential health benefits" shall\nhave the meaning ascribed by section 1302(b) of the Affordable Care Act,\n42 U.S.C. § 18022(b).\n