Friday, July 25, 2014

HHS says nine health insurance companies owe refunds to Kansas policyholders

KHI News Service

KANSAS CITY, KAN. — Federal health officials today released a list of the health insurance companies that will owe refunds to policyholders for failing to meet the spending marks for medical care set by Obamacare, including nine firms that operate in Kansas.

The 2010 Affordable Care Act required that insurers spend at least 80 percent of premium dollars collected on medical care for policyholders. Those that fail to meet the threshold are obliged to pay refunds.

Blue Cross Blue Shield of Kansas, the state's dominant private health insurance company, met the law's standards and will owe no paybacks.

"BCBSKS more than met the (medical loss ratio) requirements set out by the law and therefore is not required to make any refunds to our policyholders or members," said Mary Beth Chambers, a company spokesperson.

Chambers said the company spent 87.5 percent of premium dollars on medical care for individual policyholders and 88.4 percent and 91.5 percent, respectively, for those in small and large group plans.

Of the nine companies operating in Kansas that owe refunds for 2013 premiums, Blue Cross Blue Shield of Kansas City had the most. According to federal officials, $1,175,528 must be returned to the company's customers holding individual plans. The company met the standards for policyholders in its small and large group plans and so will owe them no refunds.

Golden Rule Insurance owes $721,922 to individual policyholders but met small and large group requirements.

Humana Insurance Company owes $687,935 to small group plan holders but met the mark for individual and large group customers.

None of the nine owes refunds in more than one category of coverage.

For individual plans, Aetna Life Insurance owes $286,388 and Companion Life Insurance owes $103,170.

For small group customers, Federated Mutual owes $340,354, John Alden Life owes $40,157, UnitedHealthcare owes $91,217 and Trustmark Life owes $168,476.

The law requires that the companies pay the refunds in one of three ways: a check in the mail to the policyholder by Aug. 1, a reimbursement to the policyholder's premium account or a direct reduction in future premiums. Employers handle the refunds to those who buy insurance through them.

Federal officials said more than 6.8 million policyholders nationwide should receive refunds, on average about $80 each.