ACA Medical Loss Ratio rebates 2019

[GTFan]

Wow, got a letter from Ambetter yesterday and they are giving back 5.40% of the policy premiums because they undercut the 80% spend minimum for claims. This is the first year I've seen a rebate, we've had ACA since 2015 with Humana, Blue Cross and now Ambetter.

The rebate amount for our Silver CSR plan was $835 (!!) which covered our entire year's premiums since we have a heavily subsidized plan. I found it interesting that consumers get the whole rebate, it doesn't go back to Uncle even if you have subsidies.

https://www.kff.org/private-insurance/issue-brief/data-note-2019-medical-loss-ratio-rebates/

Curious to see if others are getting big rebates like this, we're in Georgia. This is a record year for these given the massive premium jackups in the past few years, which were obviously higher than they needed to be. The KFF article says we'll likely get big rebates in 2020 as well since the look back is 3 years.

 

[orchid55]

We're in Georgia as well and received $975 from Ambetter. We paid all of our premium up-front and then got 90% of it back with our tax return due to lower self-employment income and many deductions to reduce said income(HSA, SEP IRA, regular IRAs). We ended up paying about $1000 for a Bronze HSA policy after all of the rebates and subsidies. We will have to declare the $975 as income next year as we did deduct the premiums on our taxes.

Ambetter has to pay as much as 15% of premiums in Arizona - some large payouts there.

 

[joeea]

Haven't heard yet.

Prior two years got a nice rebate. But those were in another state that was more strict about their MLR.

 

[CardsFan]

Does anyone but me see a problem with this? I hope someone at the Federal level makes sure this rebate (or at least the proper portion) is deducted from your subsidy at tax time.

While I am not a fan of this plan, it is the law of the land. But no way should the insured get 100% of a rebate if they are heavily subsidized. It should be proportionally distributed to the insured and the subsidizer (US taxpayers)

 

[Dtail]

Received $40 back this year from Florida Blue.

 

[littleb]

Just received our check from BCBS for $865.

 

[pb4uski]

Does anyone but me see a problem with this? I hope someone at the Federal level makes sure this rebate (or at least the proper portion) is deducted from your subsidy at tax time.

While I am not a fan of this plan, it is the law of the land. But no way should the insured get 100% of a rebate if they are heavily subsidized. It should be proportionally distributed to the insured and the subsidizer (US taxpayers)

+1 rebate should ideally go to those who paid the premiums, in proportion to their total contributions... I suspect that the government isn't angling for them because even in aggregate they are not significant in the whole scheme of things... if rebates were $1 billion countrywide it would be a lot of work to determine who gets what but for people with APC the insurer should know how much the insurer paid and how mcuh the feds paid.... those who get the PTC when they file their taxes are more complicated.

 

[orchid55]

An additional complication is people who received an APC and then had to repay some at tax time. The insurance company does not know who had to repay some advance credit because of extra income.

 

[pb4uski]

Yup.... I can see where it gets complicated... which is likely the reason the government isn't chasing the rebates.

 

[footenote]

My Minnesota Silver MLR rebate was over $500