In August some people received a rebate check from their health insurance carrier, but many more did not. To some this has led to considerable consternation to many – especially in light of the Department of Health and Human Services’ (HHS’s) public claim that Americans receiving the rebate will benefit from an average rebate of $151 per household. The explanation as to why some but not others will receive a rebate is found in the details of the Affordable Care Act.
Under the federal Affordable Care Act health insurers issuing individual and small group plans must spend 80% of the premiums paid by consumers on health care and activities to improve health care quality. The percentage of premium income an insurer spends on care and improving quality is called “Medical Loss Ratio” or MLR. The health insurers MLR is determined separately for each state’s individual, small group and large group markets. The only health insurers that are required to pay a rebate are those who do not meet the 80% MLR target.So let’s suppose you were an insured under California Anthem Blue Cross individual plan in 2012. Based on the report submitted by Blue Cross to HHS they paid 80.9% of your premium on care or improving the quality of healthcare. Consequently, you would not receive a rebate. But don’t feel too bad: many California insured persons did not.
Posted August 29, 2012 at 10:36 AM
Comments for Where’s My Health Insurance Premium Rebate?
Makes sense to me now too. BAD SENSE! Welcome to the circus complete with smoke and mirrors. Does anyone believe that insurance companies won't go around this law? As a small business owner, I see all too much how we are on the short end of everything. Government, Insurance companies, Collect sales tax on my work, and face incredible penalties if you file them late! I think that the Mafia looks like Mother Theresa next to government. Thanks for reading.
By Rick on September 05, 2012 at 10:46 AMNice article! Make sense to me now.
By Erin Maxwell on August 31, 2012 at 10:21 AM