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Depending on how you get your health care coverage, you may soon get a discount on your insurance.
An estimated 8.2 million policyholders are expected to receive $1 billion in price cuts from various insurers by Sept. 30, according to an analysis by the Kaiser Family Foundation.
Reimbursements generally average $141 per participant in public marketplace plans, $155 for small employer plans, and $78 for enrollees in large group plans (excluding companies). self insurance).
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However, discount rates can vary widely depending on your location and insurer.
The total refund of $1 billion is down from $2 billion in 2021 and $2.5 billion in 2020.
Cynthia Cox, vice president and director of the Affordable Care Act program at the foundation, said: “We’ve seen some very large rebates in the last two years – this year’s size is double. But I’d say $1 billion is still worth it.
Insurers typically either send a check to policyholders or deduct a discount from premiums (and send a check to non-enrolled individuals). If you’re in a group plan, your employer may split the discount with you, Cox said.
Health insurers send discounts to meet the ‘medical loss ratio’
So why do discounts come out?
Basically, insurance companies selling group or individual policies must adhere to a “medical loss ratio” that requires them to spend at least 80 percent of their premiums paid to enrollees on health care costs and other expenses related to a patient’s health. (For large group plans, the ratio is 85/15.) If this threshold is not met, subscribers will be refunded the difference.
Every year, the ratio is calculated on a three-year average basis. So this year’s discounts are based on financial data from insurance companies for 2019, 2020 and 2021.
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