I asked my work if I get a health insurance rebate check

[SHRED]

I asked the HR Department of the city where I work.
See below.

Are we to take the insurance corporations word on this?

Any follow-up responses I should ask?

thanks




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What I asked:

As I am sure you are aware a section of the ACA involves rebate checks being sent out over the next six weeks for overpayment based on the 80/20 rule.


My questions are:

Is the City going to be receiving a rebate? If so how much?

Also, for employees like me, who pay dependent coverage premiums, will we be getting a rebate? If so how much?


Thanks,

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Their reply:

The Patient Protection and Affordable Care Act has a provision that insurance companies working with “large employers” (over 50 employees) must submit proof to legislators that 85% of the premium paid to them by employers is being spent on claims for their members. If less than this was paid, a rebate would be owed to employers and employees. According to our insurance brokers, Anthem and Kaiser submitted data in early 2012 (for the 2011 plan year) and informed brokers that neither Anthem nor Kaiser owed a rebate for 2011 for their Large Group Employers, such as the City. This analysis will continue for the 2012, 2013, etc. plan years to determine if a rebate is due in the future.



I hope this answers your questions. If you should have any other questions, please let me know.



Thank you,

[SoutherDem]

1. Some plans were "grandfathered" which until 2014 keeps them from doing this

I don't know your situation, but a small or no rebate should mean your premiums were "fair" a large one would be you have been being screwed.

My question is if part was picked up by the employer could they keep the rebate or at least part of it?

[SHRED]

5. How can we be sure?

I wonder what the oversight is to make sure that the insurance companies are not just saying they don't need to rebate the payee?

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[ananda]

2. My understanding from what I read is that ...

... only those who pay for insurance themselves will get a rebate.

Those paying a percentage while the employer covers the rest
of the premium will not.

[lonestarnot]

3. Whut? Do you mean the 80% expenditure does not apply to group coverage? Then why the number 50?

"The Patient Protection and Affordable Care Act has a provision that insurance companies working with “large employers” (over 50 employees) must submit proof to legislators that 85% of the premium paid to them by employers is being spent on claims for their members. If less than this was paid, a rebate would be owed to employers and employees."

[JayhawkSD]

4. Not actually correct

Employers paying a percentage of the premium are entitled to keep a portion of the rebate equal to the same percentage of the premium they paid. Employers paying half of the premium, for instance, while the employee pays the other half, will keep half of the rebate. Employee will get half the rebate.

[Puzzledtraveller]

6. I work for state government

Our provider did not meet the requirement and a rebate was issued, being that the bulk of our premiums are paid by state government we did not see that rebate, it was kept as a credit by the state.