Find out if your health care provider is going to be sending you a MLR rebate check in the mail this year. The 2012 health care act has a provision that requires insurance companies to spend premium dollars, or refund “rebate” a portion back to you!
MLR Rebates In The Media
Media outlets from Texas, Minnesota, Florida, Connecticut and Georgia offer insights into what these rebates will mean on a more local level.
The Texas Tribune: Study: Texas Tops Health Insurance Rebate List
Texas consumers and businesses are poised to receive an estimated $186 million in rebates from health insurers under a requirement of the Affordable Care Act … In July 2011, the Texas Department of Insurance requested that the state be able to phase in the new mlr provision’s requirements over the course of three years, instead of implementing them immediately, but that request was denied. … The estimated figures of rebate amounts and percentage of citizens who will receive rebates were high for Texas in all three categories [of insurance markets] (Jacob, 4/26).
(St. Paul) Pioneer Press: HealthPartners, UnitedHealth Among Insurers To Pay Rebates
Some health care consumers in Minnesota and across the country might get a cut later this year of the record profits being posted by health insurers. But the per-person mlr (80/20) take could be underwhelming. The rebates are mandated by the 2010 federal overhaul of the nation’s health care system, which set a limit on the share of premium revenue that health insurers could keep for administration, marketing, taxes and profit (Snowbeck, 4/26).
Georgia Health News: Georgians Due $30 Million In Insurance Rebates
Georgia consumers will qualify for an estimated $30 million in health insurance mlr (80/20) rebates this year due to a newly implemented provision in the federal health reform law, according to an analysis released Thursday. Nationwide, health insurers will have to pay an estimated $1.3 billion in rebates, said the report by the Kaiser Family Foundation (Miller, 4/27).
Insurance companies could be required to issue nearly $14.6 million in mlr (80/20) rebates for health plans covering more than 212,000 Connecticut enrollees later this year as part of the federal health reform law, according to an analysis released Thursday by the Kaiser Family Foundation. … In Connecticut, the analysis found, three plans each in the individual, small group and large group markets would be required to issue rebates, covering 212,106 members (Levin Becker, 4/26).
The Miami Herald: Floridians To Get $148.5 Million In Refunds, Study Says
Thanks to the healthcare reform law, 325,000 Florida purchasers of healthcare insurance are likely to get rebates of $152 each later this year, according to a study released Thursday by the Washington-based Kaiser Family Foundation. That’s part of a total refund of $148.5 million due to Florida individuals and businesses, the report said. The mlr (80/20) refunds are triggered by a provision in the legislation requiring that health insurers use at least 80 percent of premiums in the individual and small business markets for healthcare, with no more than 20 percent going for administrative and sales costs and profits. For large businesses, the threshold is 85 percent that should be spent on healthcare costs (Dorschner, 4/26).
This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.
From www.HealthInsuranceRebates.org/
California
The State of California is projected to distribute up to twenty eight millions dollars worth of rebate checks to over one million residents by the August 1st. California residents will be amongst the first to receive rebates following the Supreme courts decision to affirm the Affordable Health Care act, often referred to as the Obama Care program. If you are not receiving a rebate check, its a great time to shop your policy, look for a lower price carrier offering more coverage or lower prices.
$73,905,280 (total pool) 1,877,186 (total eligible) $65 (average payout)
Florida
The State of Florida is projected to distribute over one hundred and twenty million dollars worth of rebate checks to over one million residents by the August 1st. Florida residents will be amongst the first to receive rebates following the Supreme courts decision to affirm the Affordable Health Care act, often referred to as the Obama Care program. If you are not receiving a rebate check, its a great time to shop your policy, look for a lower price carrier offering more coverage or lower prices.
$123,624,635 (total pool) 1,251,397 (total eligible) $168 (average payout)
Maryland
The State of Maryland is projected to distribute over twenty seven million dollars worth of rebate checks to over one hundred and fourty thousand residents by the August 1st. Maryland residents will be amongst the first to receive rebates following the Supreme courts decision to affirm the Affordable Health Care act, often referred to as the Obama Care program. If you are not receiving a rebate check, its a great time to shop your policy, look for a lower price carrier offering more coverage or lower prices.
$27,882,606 (total pool) 141,129 (total eligible) $340 (average payout)
New York
The State of New York is projected to distribute over one hundred million dollars worth of rebate checks to over one million residents by August 1st. New York residents will be amongst the first to receive rebates following the Supreme courts decision to affirm the Affordable Health Care act, often referred to as the Obama Care program. If you are not receiving a rebate check, its a great time to shop your policy, look for a lower price carrier offering more coverage or lower prices.
$86,526,642 (total pool) 1,001,476 (total eligible) $138 (average payout)
Pennsylvania
The State of Pennsylvania is projected to distribute over fifty million dollars worth of rebate checks to over five hundred thousand residents by August 1st. Pennyslvania residents will be amongst the first to receive rebates following the Supreme courts decision to affirm the Affordable Health Care act, often referred to as the Obama Care program. If you are not receiving a rebate check, its a great time to shop your policy, look for a lower price carrier offering more coverage or lower prices.
$51,588,303 (total pool) 575,551 (total eligible) $165 (average payout)
Texas
The State of Texas is projected to distribute over one hundred and sixty million dollars worth of rebate checks to over one million residents by August 1st. Texas residents will be amongst the first to receive rebates following the Supreme courts decision to affirm the Affordable Health Care act, often referred to as the Obama Care program. If you are not receiving a rebate check, its a great time to shop your policy, look for a lower price carrier offering more coverage or lower prices.
$166,975,840 (total pool) 1,516,721 (total eligible) $187 (average payout)
Virginia
The State of Virginia is projected to distribute over fourty three million dollars worth of rebate checks to over six hundred thousand residents by August 1st. Virginia residents will be amongst the first to receive rebates following the Supreme courts decision to affirm the Affordable Health Care act, often referred to as the Obama Care program. If you are not receiving a rebate check, its a great time to shop your policy, look for a lower price carrier offering more coverage or lower prices.
$43,127,639 (total pool) 686,738 (total eligible) $115 (average payout)
The new health reform law, the Affordable Care Act, holds health insurance companies accountable to consumers and ensures that American families are reimbursed if health insurance companies don’t meet a fair standard of value.
Because of the Affordable Care Act, insurance companies now must reveal how much of premium dollars they actually spend on health care and how much they spend on administration, such as salaries and marketing. This information was not shared with consumers in the past. Not only is this information made available to consumers for the first time, If an insurance company spends less than 80% of premiums on medical care and quality (or less than 85% in the large group market, which is generally insurance provided through large employers), it must rebate the portion of premium dollars that exceeded this limit.[1] This 80/20 rule is commonly known as the Medical Loss Ratio (MLR) rule.
On June 1, 2012, insurance companies nationwide submitted their annual MLR reports for coverage provided in 2011 to the Department of Health and Human Services (HHS). Based on this data, insurance companies that didn’t meet the 80/20 rule will provide nearly 12.8 million Americans with more than $1.1 billion in rebates this year. Americans receiving the rebate will benefit from an average rebate of $151 per household.
Under the new health care law, rebates must be paid by Aug. 1 each year. As a result, 12.8 million Americans will see one of the following:
- A rebate check in the mail
- A lump-sum reimbursement to the same account that was used to pay the premium if it was paid by credit card or debit card
- A direct reduction in their future premiums
- Their employer providing one of the above rebate methods, or applying the rebate in a manner that benefits its employees.
Consumers in every state will also receive notifications from their insurance company about the 80/20 rule. Under the Affordable Care Act, insurance companies will send a letter to subscribers every year they miss the 80/20 mark. The letter will explain the purpose of the 80/20 rule, how far the insurance company fell short of this goal, and the percentage of premium it owes in rebates. In 2012, insurance companies that meet or exceed the standard in the 2011 coverage year will send a notice to consumers explaining the purpose of the 80/20 rule and notifying consumers that they met or exceeded the standard. Insurance companies will provide consumers with unprecedented information about the value consumers get for every dollar spent on premiums. All of this information will be publicly available on HealthCare.gov.
The 80/20 rule is ensuring that insurance companies provide consumers value for their premium dollars. This rule works in combination with other consumer protections in the Affordable Care Act, like the program that reviews insurance companies’ rates to ensure that premium increases are not unreasonable. Insurance companies are now required to subject insurance premium rate increases of 10% or more to a new review process and justify these increases. Most states now have the authority to determine whether these increases are excessive, while HHS reviews rates in states that do not operate effective rate review programs. In making these determinations, HHS and the states closely review insurance companies’ 80/20 or MLR standards.
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