Why didn't I get a health insurance refund? | Get Smart Get Covered ...

Remember the ?medical loss ratio? refunds that health insurance companies were supposed to send out to some consumers this past summer? We wrote about them a while back. By now they should all have been mailed out.

In case you forgot, the health reform law required many health insurance plans to spend at least 80-85% of collected premium dollars on member medical care, beginning in 2011. Insurers who did not meet that requirement in 2011 were required to return the difference to policyholders no later than August 1, 2012.

Did you get a refund? Last week we took a question from a woman on Yahoo Answers who didn?t, but who believed she should have. She?d lost her job but heard that her former employer received a refund from the insurance company. She thought her employer was illegally withholding the refund from her and she wanted to file a complaint. What were her options?

The eHealthInsurance reply was voted Best Answer:

The law requires that refunds are made to the ?policyholder,? which, in the case of a group health insurance policy, would be the employer rather than the employees. Under some circumstances (but not all) the employer is required to use at least a portion of those funds to either 1) benefit policyholders through increased coverage or other health and wellness-related initiatives, or 2) pass on a refund to the employees commensurate with the portion of the total premium which was taken from the employee?s wages.

What that means, is that not all employers have to pass on the benefit of a refund to workers, and even those who do may opt to do something else with the money rather than send out rebate checks. Depending on the circumstances in your situation, you may not have much of a case. If you do want to file a complaint, however, contact your state?s department of insurance or the office of the insurance commissioner.

Image by Flickr user DorkyMum

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Source: http://blog.ehealthinsurance.com/2012/09/where-is-my-health-insurance-refund-consumer-qa/

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