The state insurance commissioner issued the following statement July 31, 2012:
California Insurance Commissioner Dave Jones announced that approximately 1.9 million Californians will receive health insurance premium rebates by Aug. 1. Californians will receive a total of $73.9 million in premium rebates from their health insurers. For those policyholders entitled to a rebate, the average refund or credit totals $65 per family. The rebates are the result of a provision of the Affordable Care Act (ACA) requiring health insurers in the individual and small-group markets to have a Medical Loss Ratio of 80 percent or higher. For the large-group market (51 or more employees), the Medical Loss Ratio requirement in the ACA is 85 percent or higher.
Rebate breakdown by health insurers regulated by the California Department of Insurance:
- Blue Shield of California Life & Health Insurance: $10.8 million rebate to policyholders in the individual market; approximately 239,595 subscribers impacted; $45.15 average rebate per subscriber;
- Kaiser Permanente Insurance: $277,034 rebate to policyholders in the individual market; approximately 21,823 subscribers impacted; $12.69 average rebate per subscriber;
- Connecticut General Life Insurance (CIGNA): $3.4 million rebate to employers in the large-group market; approximately 89,575 subscribers impacted; $37.70 average rebate per subscriber;
- Anthem Blue Cross Life and Health Insurance: $1.3 million rebate to policyholders in the individual market; approximately 407,429 subscribers impacted; $3.16 average rebate per subscriber;
- Aetna Life Insurance: $3.4 million rebate to employers in the large group market; approximately 84,428 subscribers impacted; $40.50 average rebate per subscriber;
- PacifiCare Life and Health Insurance: $789,615 rebate to employers in the large-group market; approximately 63,600 subscribers impacted; $12.42 average rebate per subscriber.
The California Department of Insurance is also in the process of conducting an audit of the largest six health insurers in California, as well as some smaller insurers to verify the accuracy of the data they provided about medical expenses, administrative costs and profits. “We will continue to take any and all necessary steps to ensure that health insurers are complying with the law,” Jones said. “The Department of Insurance is auditing the health insurers to make sure that consumers who are entitled to rebates receive the full amount they are owed.”