$160 million in insurance rebates due by August
The U.S. Health and Human Services Department today rejected Texas’ effort to phase in federal standards requiring insurers selling health insurance to individuals to pay at least 80 percent of premiums in medical-related expenses. As a result of the decision, Texans who purchased those policies last year will receive $160 million in total rebates from the 22 insurers who did not meet that standard. A dozen of the 34 insurers active in the state met or exceeded the 80 percent threshold.
Gary Cohen, director of oversight for HHS, said the new standard, part of the Affordable Care Act passed in 2009, will not destabilize the state’s market for individual health insurance, which he termed “very robust.” The new standard, called the medical loss ratio 80/20 rule, went into effect Jan. 1, 2011. The rebates, which apply to policies sold last year, are payable in August, said Cowan.
The largest rebate, $89.6 million, will come from Blue Cross Blue Shield, by far the state's largest writer of individual health policies with about 55 percent of the market. That comes to an average of about $220 for each of the insurer’s 407,187 covered lives. Cowan said HHS has now denied 10 states’ requests for a waiver from the rule, while at least partly granting six. Two others are pending.
-- Jim Fuquay