Did You Get a Health Insurance Refund You Didn’t Expect?

September 13th, 2012 by Will Humble Leave a reply »

If you did, you can thank the Affordable Care Act.  When you buy health insurance- the percentage of your premium dollars that your insurance company spends on providing you with health care (as opposed to what it spends on administrative, overhead, and marketing) is called a “Medical Loss Ratio”.   The Affordable Care Act limits how much of your premium dollar your insurer can spend on things besides your care.  They’re supposed to give you a rebate on the portion of premium that was over the limit.  The law requires insurers selling policies to individuals or small groups to spend at least 80% of premiums on direct medical care (and efforts to improve the quality of care).  Insurers selling to large groups (usually 50 or more employees) need to spend 85% on care and quality improvement. 

The Medical Loss Ratio part of the Affordable Care Act kicked in this year.  So far, about 400,000 Arizona residents with private insurance coverage received a total of almost $28M in refunds from insurance companies.

 

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1 comment

  1. Kartik says:

    A very sensible act considering the consumer’s best interest in mind. Hope other countries also follow the suit making health insurance more accessible to their citizens.

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