A federal rule on health insurers’ spending will bring $11 million in rebates to Georgia individuals and employers this summer.
Federal figures released Thursday 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 large employer market, where the minimum requirement is 85 percent, accounts for just $270,000 in refunds in Georgia for last year’s health plans.
Humana plans in Georgia will have to pay the highest amount in rebates — $4.5 million combined in the small-group and large employer market. full story