Health
Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that 1.9 million California residents will benefit from $73.9 million in rebates from insurance companies this summer, because of the Affordable Care Act’s 80/20 rule.
These rebates will average $65 for the 1.1 million California families covered by a policy.
The health care law generally requires insurance companies to spend at least 80 percent of consumers’ premium dollars on medical care and quality improvement. Insurers can spend the remaining 20 percent on administrative costs, such as salaries, sales and advertising.
Beginning this year, insurers must notify customers how much of their premiums have been spent on medical care and quality improvement.
Insurance companies that do not meet the 80/20 standard are required to provide their customers a rebate for the difference no later than August 1, 2012.
The 80/20 rule is also known as the Medical Loss Ratio (MLR) standard.
"The 80/20 rule helps ensure consumers get fair value for their health care dollar," Secretary Sebelius said.
Californians owed a rebate will see their value reflected in one of the following ways:
- a rebate check in the mail;
- a lump-sum reimbursement to the same account that is used to pay the premium if by credit card or debit card;
- a reduction in their future premiums; and
- their employer providing one of the above, or applying the rebate in a manner that benefits its employees.
Insurance companies that do not meet the 80/20 standard will send their policyholders a rebate for the difference no later than August 1, 2012.
Consumers will also receive a notice from their insurance company informing them of the 80/20 rule, whether their company met the standard, and, if not, how much of a difference between what the insurer did or did not spend on medical care and quality improvement will be returned to them.
For the first time, all of this information will be publicly posted on HealthCare.gov this summer, allowing consumers to learn what value they’re getting for their premium dollars in their health plan.
For many consumers, the 80/20 rule motivated their plans to lower prices or improve their coverage to meet the standard.
This is one of the ways the 80/20 rule is bringing value to consumers for their health care dollars.
For a detailed breakdown of these rebates by State and by market, please visit http://www.healthcare.gov/law/resources/reports/mlr-rebates06212012a.html .
For the text of these proposed notifications, please visit http://cciio.cms.gov/resources/other/index.html#mlr .
For more information on the MLR provision in the Affordable Care Act: http://www.healthcare.gov/news/factsheets/2010/11/medical-loss-ratio.html .
For more information on how the Affordable Care Act is creating a transparent market for health insurance, visit: http://www.healthcare.gov/news/factsheets/2010/12/increasing-transparency.html .
- Details
- Written by: Editor
A new report released Tuesday by the Department of Health and Human Services (HHS) shows that 3.1 million young adults have gained health insurance because of the health care law.
Without the health care law – the Affordable Care Act – these 3.1 million young adults would not have health insurance.
As a result of the law, the proportion of insured adults ages 19 through 25 has increased to nearly 75 percent.
The Affordable Care Act requires insurers to allow young adults to remain on their parents’ family plans until their 26th birthday, even if they move away from home or graduate from school. This policy took effect on Sept. 23, 2010.
“Today, because of the health care law, more than 3 million more young adults have health insurance,” said HHS Secretary Kathleen Sebelius. “This policy doesn’t just give young adults and their families peace of mind, it also gives them freedom. It means that as they begin their careers, they will be free to make choices based on what they want to do, not on where they can get health insurance.”
Before the Affordable Care Act, young adults were the age group least likely to have health insurance. Not only were young adults more likely to be uninsured, they were also more than twice as likely as older adults to lose private insurance coverage once they had it.
Some young adults lost coverage when they became too old to qualify as a dependent on their parents’ plans, and others lost coverage as they graduated from school or changed jobs.
A similar report released in December 2011 showed that 2.5 million young adults who would otherwise have been uninsured had gained coverage through June 2011.
Using the most recent information on insurance coverage from the National Health Interview Survey conducted by the National Center for Health Statistics, the Tuesday report finds that from September 2010 to December 2011 the percentage of adults ages 19 through 25 with insurance coverage increased from 64.4 percent to 74.8 percent. That translates to 3.1 million young adults with coverage.
This increase continues the steady upward trend in insurance coverage among young adults since the Affordable Care Act went into effect.
Starting in 2014, there will be even more health coverage options available to young adults when Affordable Insurance Exchanges, premium tax credits, and the Medicaid expansion go into effect.
To see the new HHS report, visit http://aspe.hhs.gov/aspe/gaininginsurance/rb.shtml .
To see the National Center for Health Statistics Report, visit http://www.cdc.gov/nchs/ .
To learn more about young adults, like Abby Schanfield, who are helped by the under 26 provision, visit http://www.healthcare.gov/blog/2012/04/mycare_abby.html .
To see a fact sheet about insurance increases for young adults in your state, visit http://www.healthcare.gov/news/factsheets/2012/06/young-adults06192012a.html .
- Details
- Written by: Editor
How to resolve AdBlock issue?