Health insurers will refund $5.2M to Pa. subscribers, group plans
Health insurers in Pennsylvania will refund about $5.2 million to individual subscribers and group plans because they spent too much on administration, such as salaries and profits, the Obama administration said Wednesday.
Insurance carriers across the country will give back $330 million this year because they violated a provision of the Affordable Care Act that requires companies to spend at least 80 percent of premiums on patient care, according to the Department of Health and Human Services.
“Standards like these created under the health care law are providing Pennsylvanians with immediate savings and are helping to keep costs down over the long-term,” HHS Secretary Sylvia Burwell said in a statement.
Eleven insurers selling plans in Pennsylvania were required to provide refunds, including Aetna Inc. and Golden Rule Insurance Co., which is owned by United Healthcare. Both spent too much on administration of individual policies last year, with Aetna refunding $825,000 and Golden Rule giving back $1.7 million.
Officials with both companies could not be reached for comment.
The largest health insurers in Western Pennsylvania, Highmark Inc. and UPMC Health Plan, were not required to refund premiums.
In Pennsylvania, the average refund is $75 a family; nationwide the average is $80.
Insurers last year paid $500 million in rebates to employers and individuals, or about $100 a family.
The provision, known as the Medical Loss Ratio, was first applied in full in 2011. Companies are required to provide the 2013 refunds by Aug. 1 in one of the following ways: by check, reimbursement to the account used to pay the premium, or a rebate on future premiums.
Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or firstname.lastname@example.org.
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments â either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.