Finding Out If Your Health Insurer Is Providing Value for Your Premiums
The healthcare reform law holds health insurance companies accountable to consumers and ensures that consumers are reimbursed when insurers don’t meet a fair standard of spending premium dollars on care. Because of the new “80/20 rule” in the Affordable Care Act, insurance companies generally must spend at least 80 cents of every dollar paid in premiums on healthcare or activities that improve healthcare quality. If the insurer fails to meet this standard - the “medical loss ratio” - in any given year, it must pay its policyholders the difference. This could mean a rebate check or a reduction in future premiums.
Under the healthcare law, nearly 13 million Americans are expected to benefit from $1.1 billion in rebates from insurance companies due by Aug. 1, 2012, because of the 80/20 rule. All insurance companies for the first time will send their policyholders a letter informing them of the rule and whether the insurer met the standard. Those that do not meet the 80/20 rule standard will inform consumers that they will receive a rebate.
Want to know whether your health insurance company is required to provide a rebate? HealthCare.gov, has launched a new tool that will allow individuals to enter your state and health insurance company information and see the average rebate insurers are required to pay.
For a detailed breakdown of these rebates by state and by market, please visit
To learn more about the 80/20 rule provision in the Affordable Care Act, please see http://www.healthcare.gov/law/features/costs/value-for-premium/index.html