{"identifier":"/us/usc/t42/s300gg\u201311","title":42,"num":"\u00a7\u202f300gg\u201311.","heading":"No lifetime or annual limits","text":"\u00a7\u202f300gg\u201311.\nNo lifetime or annual limits\n(a)\nProhibition\n(1)\nIn general\nA group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish\u2014\n(A) lifetime limits on the dollar value of benefits for any participant or beneficiary; or\n(B) except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary.\n(2)\nAnnual limits prior to 2014\nWith respect to plan years beginning prior to\nJanuary 1, 2014\nsection 18022(b) of this title\n(b)\nPer beneficiary limits\nSubsection (a) shall not be construed to prevent a group health plan or health insurance coverage from placing annual or lifetime per beneficiary limits on specific covered benefits that are not essential health benefits under\nsection 18022(b) of this title","url":"https://projectusc.org/usc/t42/s300gg\u201311.html","content":[{"t":"sec","id":"/us/usc/t42/s300gg\u201311","children":[{"t":"num","text":"\u00a7\u202f300gg\u201311."},{"t":"heading","text":"No lifetime or annual limits"},{"t":"subsec","id":"/us/usc/t42/s300gg\u201311/a","children":[{"t":"num","text":"(a)"},{"t":"heading","text":"Prohibition"},{"t":"para","id":"/us/usc/t42/s300gg\u201311/a/1","children":[{"t":"num","text":"(1)"},{"t":"heading","text":"In general"},{"t":"chapeau","text":"A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish\u2014"},{"t":"subpara","id":"/us/usc/t42/s300gg\u201311/a/1/A","children":[{"t":"num","text":"(A)"},{"t":"content","text":" lifetime limits on the dollar value of benefits for any participant or beneficiary; or","tail":"\n"}],"tail":"\n"},{"t":"subpara","id":"/us/usc/t42/s300gg\u201311/a/1/B","children":[{"t":"num","text":"(B)"},{"t":"content","text":" except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary.","tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"para","id":"/us/usc/t42/s300gg\u201311/a/2","children":[{"t":"num","text":"(2)"},{"t":"heading","text":"Annual limits prior to 2014"},{"t":"content","children":[{"t":"p","text":"With respect to plan years beginning prior to ","children":[{"t":"text","text":"January 1, 2014","tail":", a group health plan and a health insurance issuer offering group or individual health insurance coverage may only establish a restricted annual limit on the dollar value of benefits for any participant or beneficiary with respect to the scope of benefits that are essential health benefits under "},{"t":"ref","text":"section 18022(b) of this title","href":"/us/usc/t42/s18022/b","tail":", as determined by the Secretary. In defining the term \u201crestricted annual limit\u201d for purposes of the preceding sentence, the Secretary shall ensure that access to needed services is made available with a minimal impact on premiums."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"subsec","id":"/us/usc/t42/s300gg\u201311/b","children":[{"t":"num","text":"(b)"},{"t":"heading","text":"Per beneficiary limits"},{"t":"content","children":[{"t":"p","text":"Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage from placing annual or lifetime per beneficiary limits on specific covered benefits that are not essential health benefits under ","children":[{"t":"ref","text":"section 18022(b) of this title","href":"/us/usc/t42/s18022/b","tail":", to the extent that such limits are otherwise permitted under Federal or State law."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"text","text":"\n"},{"t":"text","text":"\n"}]}]}