Health Insurers Slated to Rebate $1.1 Billion

MedPageToday, 2012

WASHINGTON -- Health insurers will issue about $1.1 billion in rebates to some 12.8 million policyholders because of the medical loss ratio requirement in the Affordable Care Act (ACA), Department of Health and Human Services officials announced Thursday.
The ACA requires that insurers covering large groups must spend at least 85 cents of every dollar of revenue on medical care or "activities that improve healthcare quality." For small group and individual plans, they must spend 80 cents per dollar.
If insurers spend more than allowed on expenses deemed to be unrelated to patient care, they must issue rebates to policyholders.
The average rebate for each family with a private insurance policy will be $151, HHS officials said.
Policyholders will receive the rebate either as a direct payment or as a reduction in future premiums.
For those who receive insurance through their employer, the rebate will go the employer and the employer will be required to either pass it back to employees or apply it in a manner that benefits employees, according to a press release from HHS.
Consumers should also receive a notice from their insurance carrier informing them whether their insurer met the medical loss ratio requirement and, if not, how much money will be returned to the consumer.
She also covers an array of healthcare events in the nation’s capital, focusing on intersection of policy and medicine.
After earning a BA in journalism and political science at Western Michigan University, she worked at the Kalamazoo Gazette , Congressional Quartely , and wrote for several medical newsletters.
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