45% of CT individual health plans last year would not have triggered consumer rebates under new federal rules

A Hartford Courant analysis of 2010 individual health plans sold in CT finds that 45% did not spend at least 80% of premiums on members’ medical expenses. A rule requiring plans to meet that standard, termed medical loss ratio, did not take effect until this year. Plans that don’t reach that standard, overspending on administration and profit, will have to refund the difference to individuals. If the rule had been in place last year, 48,300 CT residents would have received refunds. Up to 9 million Americans could be eligible for rebates averaging $164, totaling $1.4 billion according to HHS. While almost half of CT individual plans would not have achieved the new standards last year, almost all small groups plans would have comfortably met the standard.
Ellen Andrews