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Overview:
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1. An increase in a percentage cost-sharing requirement (i.e. co-insurance), regardless of the amount.
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2. An increase in the deductible or out-of-pocket maximum by an amount that exceeds medical inflation plus 15 percentage points.
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3. An increase in copayments if the increase exceeds the greater of $5 (adjusted for medical inflation) or medical inflation plus 15 percentage points.
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4. A decrease in the employer’s contribution rate by more than 5 percentage points (measured for each tier of coverage).
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5. Eliminating all or substantially all benefits to diagnose or treat a particular condition.