Insurers Will Pay Millions in Refunds to Georgia Customers

25 July 2014

A federal rule on health insurers’ spending will bring $11 million in rebates to Georgia individuals and employers this summer. Federal figures released this week show that 304,000 Georgians will benefit from the refunds, with an average rebate of $53 per family, as a result of the “Medical Loss Ratio” (MLR) rule on 2013 insurance plans. Created by the Affordable Care Act, the MLR standard generally requires health insurers to spend at least 80 percent of the premium dollars they collect on medical care or activities to improve the quality of health care.
In Georgia, $5.5 million will go to refunds to 180,000 individual consumers, while $5.4 million will go to employers in the small-group market. In both these sectors, the required threshold is 80 percent. The Health and Human Services report said consumers nationwide will save $330 million in refunds, with 6.8 million consumers due to receive an average refund benefit of $80 per family.
The report shows that since the rule took effect, more insurers are meeting the 80/20 standard.

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