Finding Out If Your Health Insurer Is Providing Value for Your Premiums
- Created on August 1st, 2012
- By Michael Hash, Interim Director, CCIIO
When hardworking Americans pay for health insurance for their families and themselves, most of what they are paying for should be medical care, not CEO bonuses, slick advertising or administrative costs. That is why one of the pillars of the Affordable Care Act is to help consumers get good value for their health insurance premium dollars.
The health care 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 you pay in premiums on your health care or activities that improve health care 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 for you and your family.
Under the health care 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? Visit HealthCare.gov, where we have launched a new tool that will allow you to enter your state and health insurance company information and see the average rebate your insurer is required to pay.