Health insurance companies must return a total of $30 million to nearly 600,000 customers across Maryland, the District and Virginia under provisions of the 2010 federal health care law, the U.S. Department of Health and Human Services reported this week.
Nationwide, insurers owe a total of $504 million in rebates to 8.5 million customers — a sharp decline from 2011, when insurers had to return $1.1 billion to 13 million customers the first year the law was in effect. The decline in rebates reflects the industry’s improving ability to comply with a new law.
The Affordable Care Act restricts the amount of nonmedical or purely administrative spending by insurers, ordering them to spend at least 80 percent of individual-market premium revenue on medical claims and at least 85 percent of revenue in the group market. They must refund money to customers if they exceed those limits.
On a per-family basis, the 149,961 eligible Maryland consumers are getting some of the country’s largest refunds, an average of $143, above the national average of $98.
In Virginia, 235,974 consumers will get an average of $88 per family, and 210,233 District consumers will receive an average of $53. All three local figures are substantially lower than last year. Here’s a list of all states, broken down by market size.
Generally, consumers will not receive the rebates directly. Most rebates work as credits to current premiums or go to employers that pay workers’ premiums.