See, as part of the ACA, insurers who offer health coverage to individuals and small businesses must spend at least 80% of what their enrollees pay in premiums on health care claims and quality improvement activities (in NY, state law actually requires this to be slightly higher, at 82%). The other 20% or so can be used for administrative expenses like marketing and profits. For large employer plans, insurers have to spend at least 85% on claims and quality improvement.
These new rules went into effect on January 1st of last year, which means the rebates have now started to trickle down to us real folks. Here in New York, some of us have already gotten our rebates. A new report issued by the Kaiser Family Foundation (KFF) is estimating that rebates in New York will average around $150 for people who buy insurance on their own, and $125 for small business enrollees. For large employer enrollees, rebates are expected to average $142.
In total, individuals and businesses in the US are expected to get back a total of $1.3 billion – that’s no small peanuts. Thanks health reform!
Or, to learn more, here are a couple more articles on the subject from around the Web:
- “Insurers Expected to Refund $1.3 Billion To 15.8 Million Enrollees Under Reform Law,” Bloomberg BNA
- “Small Businesses to Get IOUs From Health Insurers,” John Arensmeyer, Founder and CEO of the Small Business Majority, for the Huffington Post’s Small Business America