Southern California Pipe Trades
Out of Pocket Maximums
Show Sidebar

Out of Pocket Maximums

The calendar year Out of Pocket Maximum represents the most you would have to pay out of pocket for covered services in a plan year. This includes deductibles, co-payments, and co-insurance for both in-network & out-of-network services. The Fund’s Out of Pocket Maximums are based on the Affordable Care Act guidelines. A link to the ACA website can be found here: www.healthcare.gov/glossary/out-of-pocket-maximum-limit/. Please note, the Out of Pocket Maximum for out-of-network services is twice that of in-network services.

The 2025 Out of Pocket Maximums are:

  • In-network: $9,200 per person ($18,400 per family).   
  • Out-of-network: $18,400 per person and ($36,800 per family).

The 2026 Out of Pocket Maximums are:

  • In-network: $10,600 per person ($21,200 per family).   
  • Out-of-network: $21,200 per person and ($42,400 per family).
Hide Sidebar

Navigation

Have questions?

Multi Employer Web Design by Polar Design
© Copyright 2026. All Rights Reserved.
[2026-09-23 04:23:13] manifestcache-log.WARNING: Failed to save values {"keys":["__CACHE__"],"exception":"[object] (ErrorException(code: 0): file_put_contents(): Only 0 of 371062 bytes written, possibly out of free disk space at /var/www/scptac-public/vendor/symfony/cache/Traits/FilesystemCommonTrait.php:87)"} [] ERROR [Warning]: Unknown: write failed: No space left on device (28) IN GET /southern-california-pipe-trades/benefits/scptac-health-and-welfare-fund/out-of-pocket-maximums/ Line 0 in Unknown Trace ===== SilverStripe\Dev\CliDebugView->renderTrace() DetailedErrorFormatter.php:119 SilverStripe\Logging\DetailedErrorFormatter->output(2, Unknown: write failed: No space left on device (28), Unknown, 0, ) DetailedErrorFormatter.php:54 SilverStripe\Logging\DetailedErrorFormatter->format(Array) AbstractProcessingHandler.php:37 Monolog\Handler\AbstractProcessingHandler->handle(Array) Logger.php:344 Monolog\Logger->addRecord(300, E_WARNING: Unknown: write failed: No space left on device (28), Array) Logger.php:614 Monolog\Logger->log(300, E_WARNING: Unknown: write failed: No space left on device (28), Array) ErrorHandler.php:160 Monolog\ErrorHandler->handleError(2, Unknown: write failed: No space left on device (28), Unknown, 0, )