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July 24, 2014

More than 182,000 in NC to receive $8.5 million in ACA insurance refunds

More than 182,000 North Carolinians will receive $8.5 million in insurance refunds or credits under ACA’s 80/20 rule.

More than 182,000 North Carolinians could receive $8.5 million in insurance refunds under a provision of the Affordable Care Act, the U.S. Department of Health and Human Services announced Thursday.

The value of the refunds will average $77 per family for 182,517 insurance customers, slightly less than the national average of $80. In North Carolina, 14 insurers are on the list to issue refunds to customers who have bought individual, small-business and large-business insurance policies.

The state’s largest insurer, Blue Cross and Blue Shield, is absent from this year’s list to issue refunds, meaning that the Chapel Hill organization complied with federal insurance spending rules in 2013

The refunds are triggered by the ACA’s 80/20 Rule, also called the Medical Loss Ratio, which requires insurance companies to spend at least 80 percent of premiums collected on patient care and quality improvement.

Blue Cross seized the opportunity for an impromptu marketing offensive on its website.

“They were taking too much of your premium dollar for things like administration, marketing and profits – in other words, activities other than medical care,” Blue Cross wrote.

The refunds can take the form of a check, credit reimbursement or reduction in future premiums.

However, insurers that issue group plans to employees through employers will issue refunds to the employers. The companies can keep the money to improve the quality of health care coverage, so the employees could end up receiving no money.

The deadline to issue refund notices to customers is Aug. 1.

In North Carolina, United HealthCare would owe the largest amount – $4.3 million in smal-business and large-business insurance. Time Insurance owes $861,687 to individual policyholders. Golden Rule Insurance owes $654,933 to individual policyholders. Cigna HealthCare owes $570,285 to large-business policyholders.

Other insurers include Cigna Health and Life, Coventry Health & Life, Coventry Health Care, John Alden Life, Madison National Life, Mid-West National Life, National Foundation Life, MEGA Life and Health and United States Life.

The smallest amount owed is $12,875 to individual policyholders from Companion Life Insurance.

Nationwide, the average customers refunds range from nothing in several states and territories to $522 in Minnesota. Florida has the largest number of customers affected – 981,273 are slated to receive refunds.

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