The rebates are a result of the Patient Protection and Affordable Care Act’s medical loss ratio provision, which generally requires insurers to spend at least 80 cents of every premium dollar on patient care and quality improvement.
Insurance companies that do not meet the standard will send consumers a notice informing them of the rule. The notice will also let consumers know how much the insurer did or did not spend on patient care or quality improvement, and how much of that difference will be returned as a rebate.
In all, 123,581 Pennsylvania residents will benefit from $6,875,277 in rebates from insurance companies. Nationwide, 77.8 million consumers saved $3.4 billion upfront on their premiums as insurance companies operated more efficiently, HHS said. Additionally, consumers nationwide will save $500 million in rebates, with 8.5 million enrollees due to receive an average rebate of around $100 per family.
Pennsylvanians owed a rebate will see their value reflected in one of the following:
• a rebate check in the mail
• a lump-sum reimbursement to the same account that they used to pay the premium if by credit card or debit card
• a reduction in their premiums
• their employer using rebates to improve their health coverage
The provision is intended to motivate insurers to lower prices or improve their coverage. This is the second year that it has been in effect; the average rebate per family last year was $165.