Oregon Families Receive an Average of $206 in Insurance Rebates

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Health care law is saving Oregonians money and bringing transparency to the market

Health and Human Services (HHS) Secretary Kathleen Sebelius announced that 22,346 Oregon residents will benefit from $2,928,540 in rebates from insurance companies this summer, averaging $206 per family, thanks to the Affordable Care Act.

Nationwide, 77.8 million consumers saved $3.4 billion up front on their premiums as insurance companies operated more efficiently.  Additionally, consumers nationwide will save $500 million in rebates, with 8.5 million enrollees due to receive an average rebate of around $100 per family.

Created under the Affordable Care Act, the Medical Loss Ratio standard (also known as the 80/20 rule) requires insurers to spend at least 80 cents of every premium dollar on patient care and quality improvement.  If they spend an excessive amount on profits and red tape, they owe rebates back for the difference no later than August 1, 2013.

“This new standard is increasing transparency and accountability, promoting better business practices and competition among insurance companies, and ensuring consumers receive value for their premium dollars,” said Secretary Sebelius.  “This announcement shows that more Oregonians are benefiting from the tools created under the Affordable Care Act to keep consumer costs down.”

The law has motivated many plans to lower prices or improve their coverage to meet the standard. Other Oregonians will see their value reflected through rebates later this summer.

Oregonians owed a rebate will see their value reflected in one of the following:

  • a rebate check in the mail
  • a lump-sum reimbursement to the same account that they used to pay the premium if by credit card or debit card
  • a reduction in their premiums
  • their employer using rebates to improve their health coverage

 

Insurance companies that do not meet the standard will send consumers a notice informing them of the rule  The notice will also let consumers know how much the insurer did or did not spend on patient care or quality improvement, and how much of that difference will be returned as a rebate.

The 80/20 rule works, along with the required review of proposed double-digit premium increases, to stabilize and moderate premium rates.  And, with new market reforms, including the guaranteed availability protections and prohibition of the use of factors such as health status, medical history, gender and industry of employment to set premiums rates, this policy helps ensure every American has access to quality, affordable health insurance.

For an overview of insurers’ MLR data in 2012, please visit:  http://www.cms.gov/cciio/Resources/Forms-Reports-and-Other-Resources/index.html#Medical Loss Ratio

For more information on the MLR provision in the Affordable Care Act: http://www.healthcare.gov/news/factsheets/2010/11/medical-loss-ratio.html

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Founded in 1994 by the late Pamela Hulse Andrews, Cascade Business News (CBN) became Central Oregon’s premier business publication. CascadeBusNews.com • CBN@CascadeBusNews.com

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