Friday, May 24, 2013
 

Connecticut residents slated to get $13 million from insurers

Beginning in August, nearly 138,000 Connecticut families and individuals will receive a bonus from their health insurance company -- thanks to the Affordable Care Act.

Those whose insurers spent too much on administrative cost will receive checks or reductions in premiums that average $168.

This is the result of the so-called 80/20 rule in the Affordable Care Act that prohibits health insurance companies from spending more than 20 percent of what they charge in premium on administrative costs such as salaries, marketing and executive bonuses.

"The 80/20 rule helps ensure consumers get fair value for their health care dolla," said Secretary of Health and Human Services Kathleen Sebelius.

On June 1, 2012, insurance companies nationwide submitted medical loss ratio reports for coverage provided in 2011 to HHS.

Based on the reports, HHS determined insurance companies that didn't meet the 80/20 rule owe nearly 12.8 million Americans more than $1.1 billion.

Companies that self-insure, however, are not bound by the 80/20 law, and their employees will not receive any checks or rebates.

Mike Hash, director of HHS's Office of Health Reform, said a list of the insurers who were the worst offenders of the 80/20 standard is not available because his agency hasn't processed all the information received by insurers.

The checks will be sent out unless the Supreme Court tosses out the ACA in a ruling expected next week. If the court decides the ACA is unconstitutional, the 80/20 rule will be moot.

 

Comments

Submitted by George Levinson on 06/22/2012 06:06 am

This provision is one of the best in the Affordable Care Act.
Unfortunately it may be overturned this week.

The 80% is actually termed the Medical Loss Ratio.
It means that a minimum of 80% must be spent on actual health care.
For years the insurance industry has been skimming as much as 47% of the premium dollar for non-medical expenses. For the last couple of years they have actually been raising premiums to make that number higher in anticipation of the new law.

Insurance executives should lose their jobs for this.
Their behavior is shameful.

For comparison the Medical Loss Ratio for Medicare is in the mid 90s.

If Obamacare is overturned the solution is obvious:
A single payer system, Medicare for everyone.

Submitted by Art Vandelay on 07/17/2012 08:07 am

This is SO WRONG! The government has no business in involving themselves in health care or any other aspects in our lives. Social Security is broke, along with Medicare and Medicaid. Freddie Mac and Ginny Mae had to be bailed out after the mortgage fiasco. These programs are bankrupting our nation. I wish our politicians would read their history books and learn that the Romans tried the same things we are experiencing now. Look what happened to their civilization.