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Happy health rebate month!

By Jay MacDonald ·
Friday, August 3, 2012
Posted: 10 am ET

It almost looked like junk mail. If I hadn't already been writing for months about a stealthy little health care reform perk known as the medical loss ratio rebate, I might have disposed of it unopened.

Instead, I ripped into it. Yes! A check for $803, no strings attached, courtesy of my now-former health insurance company.

I was one of approximately 12.8 million Americans who can expect to receive a whopping $1.1 billion in rebates from insurers who spent more on things like administrative costs and executive bonuses than the Affordable Care Act allows.

The medical loss ratio provision of the law, which kicked in last year, requires insurers who spend less than 80 percent of your premium dollars (85 percent for employer plans) directly on your health care to refund the difference to you every Aug. 1.

Self-employed workers who purchase their own policies are most likely to receive a rebate. When rebates are sent to employers, come may choose to put them toward future premium costs rather than return them to their employees. The size and number of rebates are expected to drop as more insurers toe the line.

For many, the MLR sounded more like a professional accreditation or major league sport -- until the checks started arriving. While the accompanying consumer explanation did little to ignite Olympic fever about the MLR itself, 800 bucks out of the blue is certainly something to cheer about.

Well, sorta. The realization quickly follows that my big windfall was, after all, money the company required me to pay them so some senior executive could keep his winter home in Barbuda stocked with Glenfiddich. Which is why I fired them in favor of a competitor whose executives at least drink Bud Light. But I digress.

If you would like to spoil the will-I-get-one surprise (and avoid inadvertently tossing away your rebate with the flyers), simply log onto, enter your insurance company or state, and you'll find a list of insurers in your state, their MLR ratios and the average rebate if any that they owe their customers.

Rebates aside, the real beauty of the medical loss ratio is that it makes it easier to tell if your health insurance company is ripping you off. 

I wish it had been around a year ago before I loaned my former insurer $800.

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August 12, 2012 at 12:11 pm

As usual, the big companies get the rebates and we get nothing, even though we paid into this for years.....