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Regulation and Compliance > State Regulation

Some States Cap Benefits

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A significant percentage of state employee health plans impose a $2 million maximum on lifetime benefits.

Researchers in the Washington office of Segal Company Inc. have published that finding in a state employee health benefits study. The researchers looked at state employee plans in all 50 states and the District of Columbia.

A majority of the plans put no limit on lifetime benefits, and 78% of the state health maintenance organization plans impose no lifetime benefits limit.

But 17% of the state HMO plans, 27% of the state preferred provider organization plans and 38% of the state high-deductible health plans impose a $2 million lifetime benefits cap.

About 3% of the HMO plans, 4% of the PPO plans and 10% of the high-deductible plans impose a $1 million lifetime benefits maximum.