As of January, health-insurance companies now are required to spend a significant portion of your premium (at least 80 percent for individual plans and 85 percent for large group plans) on medical care that improves health-care quality. That’s because of the medical-loss ratio, which is a new provision of the Affordable Care Act that was issued by Department of Health and Human Services (HHS) to control administrative costs.
Health-insurance companies are required to file reports on how they are spending that money with HHS. If companies fail to meet the standards, you will receive a rebate beginning in August 2012.
But don’t expect to hit the jackpot: You’ll reap only the percentage of the premium that you pay. For individual plans in which the customer pays 100 percent, the average rebate is expected to top out at $164.