42 U.S.C. § 300gg–11 — No lifetime or annual limits

(a) Prohibition (1) In general: A group health plan and a health insurer selling group or individual coverage cannot set: (A) Lifetime dollar limits on benefits for any participant or beneficiary; or (B) Annual dollar limits on benefits for any participant or beneficiary — except as allowed in paragraph (2). (2) Annual limits prior to 2014 For plan years starting before January 1, 2014, a group health plan or insurer could only set a "restricted annual limit" on the dollar value of benefits, and only for essential health benefits (as defined in section 18022(b) of this title), as the Secretary determined. In defining "restricted annual limit," the Secretary had to make sure people could still get needed services with as little effect on premiums as possible. (b) Per beneficiary limits Subsection (a) does not stop a group health plan or insurer from setting annual or lifetime limits on specific covered benefits for each beneficiary, as long as those benefits are not essential health benefits under section 18022(b) of this title, and the limits are otherwise allowed under federal or state law.