Law Triggers $57M In Health Insurance Rebates

Thousands of individuals and small businesses will receive $57 million in rebates from five large health insurers that reflect a portion of the difference between what carriers charged in 2011 and what they actually spent on health care last year.

According to the state Division of Insurance, rebates will be delivered from Fallon HMO, Harvard Pilgrim HMO, Harvard Insurance Company, Neighborhood Health Plan and Tufts HMO to 50,000 individual policyholders and an additional 50,000 small businesses and their employees.

Individuals will receive $205, on average, and businesses will receive $936, on average.

The rebates are worth about $10 million more than insurers initially estimated and reported to state insurance regulators.

Under a 2010 state law, insurers last year must have spent at least 88 percent of premium dollars on medical costs and must rebate part of the difference if they spend less than that amount. The rebates must be calculated within six months of the end of each year.

Payments are made to individuals who buy their own insurance or to employers in the small group market that by insurance for their employees.

In a statement, Insurance Commissioner Joseph Murphy said the rebates show how the 2010 law directly addressed costs.

“Insurers in this state understand that their operations remain under careful scrutiny to ensure that cost control and containment remain a priority going forward,” Murphy said.