| Business

Larger text Larger text Smaller text Smaller text | Order Photo Reprints

Health insurers will refund $5.2M to Pa. subscribers, group plans

Email Newsletters

Sign up for one of our email newsletters.

On the Grid

From the shale fields to the cooling towers, Trib Total Media covers the energy industry in Western Pennsylvania and beyond. For the latest news and views on gas, coal, electricity and more, check out On the Grid today.

Thursday, July 24, 2014, 12:01 a.m.

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

Add Alex Nixon to your Google+ circles.

Subscribe today! Click here for our subscription offers.




Show commenting policy

Most-Read Business Headlines

  1. German financial giant Allianz SE slashes coal investments
  2. Black Friday loosens its hold on the holiday season
  3. Union leaders warn Post-Gazette newsroom of possible layoffs
  4. Coke had hand in shaping nonprofit health group, emails show
  5. Covestro leader MacCleary finds stability amid change
  6. Feds upgrade GDP’s growth
  7. Mall stores required to open for Thanksgiving
  8. New rules proposed for high-speed traders
  9. Stocks shake off Middle East tensions, drop in consumer confidence
  10. Hedge fund Elliott Management grabs 6.4 percent stake in Alcoa
  11. Home rental prices rise at slower pace in October