Posted: Jul 6, 2012 3:54 PM by Matt Evans
Updated: Jul 6, 2012 10:47 PM
JEFFERSON CITY - About 590,000 Missourians are owed nearly $61 million from insurance companies after the federal health care law was upheld last Thursday. The law requires insurance companies to spend at least 80 percent of premiums on healthcare and then the rest can be spent on administration, such as salaries and marketing. The U.S. Department of Health and Human Services said several Missouri insurance companies are out of compliance, so they must now refund that difference to the consumers. The average refund per policy is about $170 in Missouri.
Anthem Blue Cross Blue Shield owes Missourians the most at almost $34 million.
"Predicting the cost of care is an inexact science because there are many variables which can cause actual costs to be higher or lower than expected," said Kim Ashley, Anthem Director of Public Relations, in a statement released Friday. "Generally, we are able to forecast claims cost with a high degree of accuracy as was the case last year. Still, in some of our markets, in some lines of business, we spent less than we anticipated on medical claims."
Ashley went on to say that the Missouri rebates are less than 2 percent of the premiums the company took in last year.
Missouri insurance companies owe more than most other states. Companies in the Show-Me-State owe more than companies in 44 other states across the nation. That's because insurance companies in Missouri aren't regulated as much as companies operating in other states.
"Missouri is one of the states where there's actually very little insurance regulations with insurers that operate in Missouri," said Ryan Barker, the director of health policy for the Missouri Foundation for Health. "We have a Department of Insurance, but it doesn't have a lot of authority to review rate increases every year."
Across the country, insurance companies owe more than $1.1 billion to almost 12.8 million Americans. Those rebates are due by August 1. According to the U.S. Department of Health and Human Services, as of June 3, 17 companies owe Missourians $60,664,564. Anthem Blue Cross Blue Shield owes the most at almost $34 million. United Healthcare owes the second most at more than $16 million and Blue Cross and Blue Shield of Kansas City owes third with a little more than $5.5 million. Here's a full list of what companies owe in Missouri:
Not everyone who has a policy with these companies will get the refund. It depends on a variety of factors, including if the policy holder has a personal plan or an employer's plan. The refunds are due to policy holders by the end of July.