Insurers paid $478M in rebates last year, study finds

For 2014, health plans reimbursed customers $478 million in rebates as a consequence of the Medical Loss Ratio provision in the Affordable Care Act, equating to approximately $129 per benefiting family, according to a data aggregation from Mark Farrah Associates

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The MLR provision established by the ACA requires health insurers who fail to spend specified percentages of their premium income on medical and quality care improvements to pay consumers rebates. “Overall, the rebates paid to costumers were a relatively small portion of industry premiums,” the report concluded.

Customers were rebated more money last year than in 2013, the data finds. In 2013, health plans reimbursed customers $335 million, equating to approximately $80 per family receiving a refund. MFA also broke down the findings by individual, small group and large group rebates.

Below were the 10 states with the highest MLR rebates in 2014:

  1. California: $98.1 million
  2. Florida: $60.3 million
  3. Michigan: $25.7 million
  4. Maryland: $23.7 million
  5. Mississippi: $20.9 million
  6. Georgia: $17.4 million
  7. Texas: $16.4 million
  8. South Carolina: $15.1 million
  9. Washington DC: $14.6 million
  10. Missouri: $13.9 million

More articles on payer issues: 

BlueCross, Carondelet reach last-minute deal to resolve contract dispute
WellCare to transition pharmacy benefits management to CVS Health
3 trends and issues for ACA open enrollment

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