Health Insurance Premium Rebates

Under the Affordable Care Act, health insurance providers are required to submit annual data to the Department of Health and Human Services (HHS) regarding use of premium payments.  It’s a protection that ensures customers get value for their health insurance and is referred to as the “Medical Loss Ratio” standard or the” 80/20” rule.  At least 80% of premiums received must be spent on medical care services, including doctor and hospital bills as well as activities to improve health care quality and patient safety.  Only 20% can be used for administrative costs and profits, including executive salaries, overhead and marketing.

In 2019, Blue Cross NC spent 79.9% of premium dollars on health care and activities to improve health care quality.  Since it missed the target by 0.1%, Blue Cross NC must rebate 0.1% to its 2019 ACA members.  Emails went out August 3^rd encouraging members to log in to Blue Connect to make sure their address on file is correct.

Here are the key points listed in a recent Agent News article made available to appointed agents.

• Rebates will be issued to all eligible subscribers by September 30^th.  Rebate notifications will be mailed to some customers in August.
• Eligible individuals will receive either a rebate check in the mail, or a credit on their October bills.
• We will issue credits to individual, under-65 customers who have a monthly premium that is larger than their refund amount.
• We’re sending checks in the mail to those who:
• have a monthly premium that is less than the amount of the refund, or
• are no longer with Blue Cross NC, or
• are Student Blue members
• Customers can refer to bluecrossnc.com/MLR for more information.
• If customers have questions, they should call 1-866-669-6258.

Stay well,

❤

Tara