- Associated Press - Thursday, July 24, 2014

More than $21 million in health insurance rebates will be coming to consumers in the Carolinas from companies the federal government says spent too many premium dollars on profits and red tape last year.

The U.S. Department of Health and Human Services released data Thursday showing that more than 205,000 consumers in South Carolina will receive more than $13 million in rebates. That’s an average refund of $92 per family.

In North Carolina customers will be receiving more than $8 million in rebates in the coming weeks. More than 182,000 consumers will benefit and the refund amounts to about $77 per family.

Nationally, nearly 7 million consumers nationwide will receive about $330 million in refunds. The refund nationally will average about $80 per family.

The refunds are being made, for the third year in a row, under the federal Affordable Care Act, sometimes known as “Obamacare.”

The law created the so-called the Medical Loss Ratio Rule - also known as the 80/20 rule - with the intent of making insurance companies more efficient. Under the rule, health insurance companies must spend at least 80 percent of premium dollars on “patient care and quality improvement activities,” according to a release issued with the new data.

Those companies that devote too much to profits and red tape owe refunds. The HHS report concluded that, last year alone, consumers saved $3.8 billion on their premiums upfront because companies were operating more efficiently.

Those entitled to refunds will get them in one of several ways. They may get a refund check in the mail or a lump-sum reimbursement to the account used to pay the premium. Or customers may receive a reduction in future premiums.

Employers providing health insurance must provide the refunds in similar ways or can choose another method that helps their workers, such as enhancing benefits.


On the Internet:

HHS report on medical loss ratio: https://go.cms.gov/1jXpP0R

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