The U.S. Department of Health & Human Services (HHS) announced on Friday that it has launched a new online tool to help you find out whether your health insurance company is required to pay you a rebate on August 1, 2012, a new benefit under the Patient Protection & Affordable Care Act, President Obama’s signature Health Care Law.
If your insurer must pay rebates under the law, the new tool will tell you how much, on average, the insurer will be required to pay policyholders in your State.
“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,” HHS said in an announcement posted in its HealthCare Blog on Friday, July 13.
This is because the Patient Protection & Affordable Care Act, the new Health Care Law that some call “Obamacare,” holds health insurance companies accountable for how they spend your premium dollars. The law requires that insurance companies must spend at least 80% of each premium dollar on actual health care, rather than on administrative costs, executive salaries, or profits for the company. This 80/ 20 rule is called the “Medical Loss Ratio (MLR)” Rule under the law.
Insurers who fail to comply with this rule and fail to spend at least 80% of your premium dollars on actual medical care, are required by the Health Care Law to issue premium rebates to their policyholders by August 1, 2012.
“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.” The rebates are due to be paid by August 1, 2012.
The New Online Tool Launched by HHS
Find Out the Average Rebate Your Insurer Must Pay Policyholders in Your State. The new tool launched by HHS, located at HealthCare.gov, allows you to find out the average rebate your insurer is required to pay to policyholders in your State under the 80/ 20 rule (officially called the “Medical Loss Ratio (MLR) Rule) of the Affordable Care Act.
Here is a copy of the online form you can fill out. Just choose your State, enter your insurance company’s name, and select “MLR” (for Medical Loss Ratio information), and click Search:
A page will then be displayed providing information about your insurance company’s compliance. At the bottom of the page, a table will tell you whether the company met the “MLR Standard” requirement to spend at least 80% of each premium dollar on actual health care, and if not, the average amount of premium rebates the company must pay to policyholders in the individual, small group, and large group markets in your state by August 1, 2012. Here is an example:
Find Out If Your Insurer Has Proposed to Increase Premiums under Your Policy. The new tool also provides a form where you can find out if your insurance company has requested to raise premiums to policyholders in your State.
Under the Affordable Care Act, health insurance companies must, for the first time, tell consumers when they want to increase insurance rates for individual or small group policies by an average of 10% or more, and must undergo a review process where they must justify any such rate increases. More information about the Rate Reviews required under the Affordable Care Act is available from HealthCare.gov.
As a consequence of the Rate Reviews required by the Affordable Care Act, it is not unusual to find via this tool that your insurance company may have requested a premium increase for your State, but after the Rate Review process, withdrew the requested increase.
This is another way in which the Affordable Care Act is making health care more affordable for consumers. See, HHS Notes Successes of Affordable Care Act (Obamacare) on its 2-Year Anniversary
How You Will Receive Your Rebate
According to the information provided via the new tool on HealthCare.gov, insurers that owe rebates must pay—and provide a notice to consumers—by August 1, 2012.
“Consumers may see the “rebate” in a number of ways,” HHS states. “These include:
- A rebate check in the mail;
- A lump-sum reimbursement to the same account that was used to pay the premium if it was paid by credit card or debit card;
- A direct reduction in their future premiums; or
- Your employer using one of the above rebate methods, or applying the rebate in a manner that benefits employees.”
“People who have individual insurance policies will receive the rebate directly from the insurer,” HHS states. “In the small group and large group markets, the rebate is usually paid to the employer, which may use one of the above rebate methods, or apply the rebate in a manner that benefits employees,” HHS explains.
Visit HealthCare.gov to find out more about the $1.1 Billlion in rebates that almost 13 million consumers will be receiving from their insurance companies under the Medical Loss Ratio (MLR) rule (also called the 80/20 rule) of the Affordable Care Act, including:
- Key Features of the Law: Value for Your Premium Dollar
- Report: Providing Value and Rebates to Millions of Consumers
- Holding Insurance Companies Accountable
See related HelpingYouCare™ reports on:
- News on Health Care Reform;
- Editorials: What Needs Improvement, With Your Comments;
- Advocacy: Proposals for Reform, With Your Comments;
- Legislation: Pending & Recently Adopted; and
- International Health Care Compare: Information on Health Care & Long-Term Care Solutions in Other Countries.
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