Blue Shield To Repay $82M; Anthem, Kaiser Say They Owe No Rebates
Blue Shield of California has to issue $82.8 million in rebates to consumers and small employers under an Affordable Care Act provision, the Los Angeles Times reports. The state's other two largest insurers -- Anthem Blue Cross and Kaiser Permanente -- say they do not owe any refunds this year.
Under the ACA, insurers that do not spend at least 80% of premiums on medical care must issue refunds.
Details of Rebates
According to the Times, Blue Shield last year spent 76.8% of premiums on medical care.
As a result, the insurer owes:
- $61.7 million to about 450,000 individual consumers, with an average rebate of $136; and
- $21.1 million to about 19,000 small businesses.
The insurer said letters and rebate checks will be sent to eligible consumers by Sept. 30.
Blue Shield said it missed the 80% threshold in part because of enrollment uncertainty under the ACA.
Spokesperson Steve Shivinsky said, "It reflects a lot of the uncertainty in the marketplace we were entering into with the [ACA]" (Terhune, Los Angeles Times, 8/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.