i got a letter today from my insurance company that came with a $750 check. i will summarize it:
“the affordable care act requires (my insurance company) to issue a refund (to me) if it does not spend 80% of the premiums it receives on health care services”
“no more than 20% of premiums may be spent on administrative costs such as salaries, sales, and advertising…this requirement is referred to as the “medical loss ratio” standard or the ’80/20 rule’. The 80/20 rule in the a.c.a. is intended to ensure that consumers get value fro their health care dollars.”
“in your state (my insurance company) spent only 57.8% of a total of $22,443,706.00 in premium dollars on health care and activities to improve health care quality. since it missed the target in your state by 22.2%…(they) must refund 22.2% of your health insurance premiums.”
do you realize what that means? my insurance company pulled in $22,443,706 and only spent $12,972,462.06 on health care leaving $9,471,244.00 in their coffers.
let me just spell that out: nine million, four-hundred and seventy-one thousand, two hundred and forty four dollars that was not spent on health care.
to put it into perspective. my insurance company is a tiny tiny potato. it’s not etna or one of the big wigs. it is a small sub-branch of a giant company who legally separated themselves from the empire (wink wink) to thwart the patient protection act in mississippi. they did this to avoid offering maternity care because mississippi has a very generous c.h.i.p.s. program in place that helps pregnant women and children with health care costs and for mississippi it has a relatively high income threshold.
for all who think that the affordable care act tramples your rights, i’m sorry but you are uninformed and obviously don’t pay for your health insurance out of your own pocket. if you receive insurance from your work, then you will more than likely be untouched. in mississippi, in particular, most people will never ever ever ever meet the minimum income to be required to purchase health insurance. just a fact, not a judgement. check the census data. and those who opt to pay or may be made to pay, will enjoy a lowered premium for expanded services.
i know it’s been two days of polotics in the ande sphere, but after 10 years of paying out of pocket for our health insurance and in return receiving painfully poor coverage and hard to decipher coverage with high deductibles which lead to annual medical expenditures that leave me wondering at the end of every year if we would have just been better off without it, i am absolutely elated. and i’m not going to hide it.