Because their health insurer failed to spend enough money on patient care, more than 100,000 Utahns will soon get a check in the mail, a rebate to their bank account or a smaller-than-expected insurance bill.
Under the Affordable Care Act, insurers must spend at least 80 percent of the money collected through premiums on patient care. Those who fail to hit the mark have to give refunds to their customers.
Health insurers who fail to spend at least 80 percent of premium money on care must send refunds to their customers. Here’s a breakdown of those refunds:
Total refunds » $332,152,474
Consumers » 6,816,423
Average refund » $80
Total refunds » $3,296,969
Consumers » 104,576
Average refund » $81
Source: Centers for Medicare and Medicaid Services
A report released Thursday by the federal government shows that 104,576 Utahns will split $3.3 million, for an average of $81 per family. That’s down from the previous year, when nearly 140,000 people received $4.6 million in refunds.
What’s happening in Utah is happening nationwide: Insurance companies are getting better at hitting that 80-20 split.
The total amount of rebates nationwide dropped from $519 million in 2012 to $332 million in 2013.
The 80/20 rule is "providing Americans with immediate savings and helping to bring transparency and accountability to the insurance market over the long-term," Health and Human Services Secretary Sylvia Burwell said in a statement.
In Utah, Regence BlueCross BlueShield handed out $3.25 million in rebates last year to its customers in the small group market, which covers companies with 50 or fewer employees.
That amount dropped to $1.66 million this year. About 49,400 people will get an average refund of $92.
In the large group market, roughly 43,700 people who work at bigger companies will receive an average refund of $50.
UnitedHealthcare is handing back $508,000, about the same as it returned the previous year, while Cigna Health and Life’s refund jumped from $76,000 to $301,000.
Almost 11,500 people insured through the individual market will get an average refund of $133.
Four insurance companies are offering rebates to this group, the biggest being the $539,400 from Altius Health Plans. That same insurer handed back $306,000 last year.
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