October 11, 2012 by David K. Sutton
Fact of the Day: Your Health Care Insurance Company Could Owe You a Refund
The Affordable Care Act (Obamacare) requires your health care insurance company to spend most of your premium on health care, not administrative costs and profits.
The law requires insurers selling policies to individuals or small groups to spend at least 80% of premiums on direct medical care and efforts to improve the quality of care. Insurers selling to large groups (usually 50 or more employees) must spend 85% of premiums on care and quality improvement. – HealthCare.gov, Value for Your Premium Dollar
If your insurance company exceeds this limit, they must refund the difference. If you buy insurance directly (not through your employer), you should personally receive this refund. If your have insurance through your employer then the refund goes to your employer, which in turn is supposed to lower your premium costs.
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