81,000 to receive rebates

Ohio estimates health savings in state at $11.3M

7/24/2012

CLEVELAND -- More than 81,000 Ohio families will be getting health insurance rebates this summer that will total $11.3 million across the state, according to a published report.

The average refund will be $139, but some of the 81,500 families will receive hundreds of dollars more, the Plain Dealer in Cleveland reported.

The Ohio rebates are part of the $1.1 billion that insurers nationwide must return to nearly 12.8 million Americans under the Affordable Care Act, according to the U.S. Department of Health and Human Services.

The act requires insurance carriers to spend 80 percent or 85 percent of premiums collected on medical care or care improvements.

The remaining 15 percent or 20 percent can be spent on salaries, advertising and other administrative expense or kept as profit, but anything over that must be returned to customers.

Officials with some companies have said it is difficult to predict the cost of care. An Anthem Blue Cross and Blue Shield spokesman says customers used fewer services last year than projected, and the rebate amount is only 0.1 percent of the total premiums Anthem took in last year.

"It's a very small percentage," Anthem spokesman Kim Ashley said.

Insurance companies must provide their numbers to Health and Human Services, which determines whether they owe rebates and how much.

The new regulation is critical to ensuring that Americans get the best value out or their insurance coverage, said Teresa Miller, acting director of Health and Human Services' Oversight Group at the Center for Consumer Information and Insurance Oversight.

No one in Ohio who's covered by a large group plan -- a company with 51 or more employees -- is due a rebate, according to Health and Human Services.

The Ohio Department of Insurance says about 66 percent of Ohioans insured through employer health plans are in self-funded plans, which are exempt from the regulation.

All insurance companies are required by law to send letters to policyholders no later than Aug. 1 stating whether the company owes a rebate and how much. The deadline for sending the rebates also is Aug. 1.

Companies receiving the rebates can distribute them as checks to employees, a deduction from next year's premium, or as an additional health benefit, according to Health and Human Services.