Accident & Health FundamentalsQuestion 24 of 716
With respect to Essential Health Benefits on an ACA-compliant plan, an insurer may impose:
a.A $250,000 annual dollar cap on inpatient hospital and surgical benefits
b.No annual or lifetime dollar limits on Essential Health Benefits
c.A $1,000,000 lifetime dollar cap on all essential benefits combined
d.Only an annual dollar cap on essential benefits, but no lifetime cap
Explanation
The ACA prohibits both annual and lifetime dollar limits on Essential Health Benefits. Non-essential benefits may still be subject to limits, but the ten categories of Essential Health Benefits (hospitalization, prescription drugs, maternity, etc.) must be offered without dollar caps.
Law Reference: ACA – annual & lifetime limits (42 U.S.C. §300gg-11)This topic, taught in full in the California Life & Health Insurance Producer Exam guide. California Life & Health Insurance Producer Exam — Complete Study Guide (2026) — PDF + EPUB, $19.99 · 14-day refund →
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PrepPass team · Verified against California Life & Health Insurance License Exam · How we review
Reviewed by John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verify)