Warm Southern Breeze

"… there is no such thing as nothing."

Healthcare Insurance policy holders to get rebate in FL

Posted by Warm Southern Breeze on Monday, April 16, 2012

Thanks to “ObamaCare,” which requires health insurance companies to spend 80% of health insurance premiums on actual healthcare, instead of CEO compensation, stockholder payout, advertising, overhead, and other non-healthcare delivery, Floridians will be receiving a rebate from the money they were overcharged.

Thanks, President Obama!

Florida health insurers to rebate estimated $113 M

Consumers with individual policies may get $143 to $949 each

April 13, 2012|By Bob LaMendola, Sun Sentinel

Floridians who buy health insurance without the help of an employer can expect estimated rebates of $143 to $949 in August because of the federal health care overhaul.

About 157,000 individuals and families qualify. In addition, an estimated $65 million in health insurance rebates are in line to be split among workers covered at 352,000 small businesses, the Sun Sentinel found by analyzing reports filed this month by 15 of the largest insurers in Florida.

Don’t expect cash back if you get health coverage from an employer of more than 50 workers. Few of their insurers will owe rebates, and many companies are self-insured and not affected by the health law, insurance experts said.

“This is important for consumers,” said Richard Polangin, health care policy coordinator with the advocacy organization Florida Public Interest Research Group. “They already pay extremely high prices for health insurance.”

Individuals don’t need to do a thing to obtain their money. Insurers must notify them by Aug. 1 if they are due a refund and pay that month.

The rebates can be paid with a check or a credit toward next year’s premium. Rebates on group policies go to the employer, which must promise in writing to pass the money to employees or use it to benefit their health coverage.

The rebates stem from a rule in the health care overhaul law that said, starting last year, insurers had to spend at least 80 percent of their premiums on medical costs. The rest can go to administrative costs and profits. If insurers spend too much on overhead, they must refund the difference to policyholders.

The Sun Sentinel calculated rebate estimates from 2011 year-end financial reports that the 15 health insurers filed this month with the National Association of Insurance Commissioners. Insurers cautioned that the figures were preliminary and may change in a final report to the federal government on June 1.

The analysis of the 15 Florida insurers showed that 11 would owe rebates of $48 million on individual policies. Topping the list was national giant Humana at $16 million, Connecticut General at $7.7 million, Time Insurance at $6.9 million and Coventry Health at $5.3 million.

Humana officials declined to comment.

Three of the companies also would owe small employers, including Florida Blue (formerly Blue Cross and Blue Shield of Florida) at $39 million and United Healthcare at $17.7 million.

“More money should go for health care costs and less should be siphoned off. It makes our health care system more efficient. It limits excess profits to investors,” Polangin said. “If some insurance companies can comply and have been for quite some time, why can’t the others? They have to get rid of their excess costs.”

Last year, when officials tried to predict the rebates, estimates were much larger. TheU.S. Department of Health and Human Servicespegged Florida’s figure at $174 million for individual policies alone. But insurers took steps in 2011 to avoid rebates, by lowering premiums and co-payments and reducing overhead, HHS officials said.

“We’re more than happy with that,” said HHS spokesman Brian Chiglinsky. “Consumers are getting more value for their dollar, whether it’s rebates or lower premiums and costs.”

For example, Golden Rule Insurance, a subsidiary of United Healthcare, had been forecast last year to owe $33 million on Florida individual policies. The company’s new figures indicate no refunds. The company declined to comment.

But insurance agents were skeptical, saying the impact has been small.

“I haven’t seen it. The trend on premium increases was a little smaller than in the past but not by very much,” said W. Adam Clatsoff, president of Adcahb Medical Coverages, an 11-office agency based in Coral Springs.

Clatsoff, a member of the state’s Florida Health Insurance Advisory Board, said he doubts the rebates and health care law would help consumers much because it does little to control health care costs.

America’s Health Insurance Plans, the industry’s trade group, estimates that despite the rebates, the costs of the health care overhaul would raise health insurance premiums by 2 percent this year.

blamendola@tribune.com or 954-356-4526

Health insurers will owe rebates to customers in August if they spend more than 20 percent of their premium dollars on administration, profit and overhead.

An analysis of preliminary financial data filed by 15 large insurers in Florida found that the following are in line to owe rebates. Insurers will issue final figures in June.

Company Number of Policies Estimated Total Rebate $ Estimated Average Rebate $
Humana Health   30,657   $12,320,241   $401.87
Connecticut General   35,249   $7,793,997   $221.11
Coventry Health Plan   21,603   $5,267,086   $243.81
Time Insurance    6,144   $4,366,021   $710.62
Humana Insurance   14,287   $3,733,534   $261.32
Mid-West    2,818   $2,631,995   $933.99
Preferred Medical   18,022   $2,574,950   $142.88
Florida Blue mini-med plan   14,109   $2,275,980   $161.31
MEGA Life    2,478   $1,930,486   $779.05
United American mini-med plan    5,223   $1,179,045   $225.74
Freedom Life    2,705     $998,130   $368.99
American Republic       594     $563,751   $949.08
TOTAL policyholders DUE REBATES 156,643 $48,190,066   $307.64
Plans among the 15 NOT projected to owe rebates:
AvMed     7,208
Florida Blue (Blue Cross Blue Shield) 275,586
Coventry Health & Life     6,629
Golden Rule   67,781
Health Options    1,371
Humana Medical    2,759
Note: Other companies may owe rebates also. Source: Individual company reports filed with National Association of Insurance Commissioners, Florida Office of Insurance Regulation

Note: Other companies may owe rebates also.

Source: Individual company reports filed with National Association of Insurance Commissioners, Florida Office of Insurance Regulation




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