Checks In The Mail: Millions Expected To Receive Insurance Rebates Totaling $1.3 Billion

Washington, DC, United States (KaiserHealth) – Millions of consumers and small businesses will receive an estimated $1.3 billion in rebates from their health plans this summer under a provision of the health care law that effectively limits what insurers can charge for administration and profits, a new study projects. Almost one third of people who bought their own insurance last year will get rebates averaging $127, according to an analysis of state data by the nonpartisan Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) “This alone is not going to make health insurance affordable for large numbers of people, but it is getting excess administrative cost out of the system,” says Larry Levitt, a study author. The percentage of consumers and businesses in line for rebates varies widely by state. In Texas, for example, 92 percent of consumers who purchased individual policies are expected to get rebates because insurers spent too little of their premium dollars on medical care. But in Vermont, Rhode Island, Iowa and Hawaii, insurers are likely to owe less than 1 percent of consumers who bought policies on the individual market. Under the federal law, insurers must spend at least 80 percent of premium revenues on medical costs or quality improvements; the remainder can go toward administrative costs, sales commissions and profits. If companies set premiums too high, rebates in the form of checks or discounts off future premiums are due consumers and businesses by Aug. 1. The requirement, aimed at holding insurers more accountable and slowing premium increases, went into effect last year and applies to all health plans, except those offered by self-insured employers. Insurers had criticized the rule as being too strict, while sales agents feared insurers would reduce their commissions. The figures are based on the latest estimates insurers provided state regulators, so the actual rebate amounts may differ, according to the report’s authors. The total dollar projection is similar to one released Wednesday by a Goldman Sachs analyst, but slightly lower than one made previously by the government, which had said rebates could be worth up to $1.4 billion. Nationally, an estimated 3.4 million people who bought their own coverage are projected to receive rebates this year from 215 insurance plans, according to the study. The biggest dollar amounts are expected to go to consumers in Alaska, where per person rebates are expected to average $305, Maryland, $294, Pennsylvania, $243 and Idaho, $241. Insurers hit the spending targets for policies sold directly to consumers in several states, including Hawaii, Maine and …

April 26, 2012No CommentRead More