Some of you may have recently received a check in the mail from your insurance company and wondered “why.”
The answer is an important, but often overlooked, provision of the Affordable Care Act (ACA): the Medical Loss Ratio (MLR) rule.
Here is what that means for you. Health insurers collect premiums from policy holders every month. They use the money to pay for health care claims and administration costs (such as salaries, marketing and profits for investors). The medical loss ratio stipulates that insurance companies must spend at least 80 cents on the dollar of premiums collected on health care claims (85 cents for large groups). If they spend less than that they have to rebate the difference back to the insured group or individual. That could mean more money in your pockets!
It is important to understand that rebates are not based on the experience of an individual policy holder or group policy but based on the insurance company’s overall compliance with the medical loss ratio standards in Florida.
Rebate checks for 2017 are being mailed in August. I just received our rebate check for the 6th year in a row!
Watch your mail box and share your rebate story at www.healthyfla.org/shareyourstory.