North Carolina health insurance companies owe $8.5 million in rebates

U.S. Health Insurance

Insurers must return some $8.5 million in premiums to consumers and businesses

Health insurance companies in North Carolina will be reimbursing consumers and businesses some $8.5 million, according to the state Insurance Commissioner Wayne Goodwin. These insurers have failed to comply with the medical loss ratio, a provision of the Affordable Care Act that requires insurers to spend no less than 80% of the money they collect through premiums on medical care. For insurers providing coverage to businesses, the medical loss ratio is set at 85%.

Medical loss ratio continues to weigh on insurers

Insurers throughout the country have been failing to comply with the medical loss ratio, which has resulted in them having to return money to consumers and businesses. This is not necessarily a new problem that insurers have been encountering, of course. Over the past few years, many insurers have found it difficult to comply with the provision, placing some insurers under a great deal of financial strain. This has been the case for UnitedHealth, which recently announced that it will be pulling out of health insurance exchanges throughout the country.

UnitedHealth owes the most among the state’s insurers

U.S. Health InsuranceIn North Carolina, UnitedHealth owes the majority of rebates that are meant to be returned to consumers and businesses, some $4.1 million for small-group policies and $777,000 for large-group policies. The insurer was unable to meet the medical loss ratio in 2014, and now will have to return money that it has collected on the premiums associated with the coverage that it provides to both consumers and businesses. Coventry Health and Life Insurance is also required to return money to consumers.

Insurers are expressing worry over the Affordable Care Act

Some large health insurance providers have begun voicing their concerns about the Affordable Care Act. The federal law has ensured that millions of people have found access to health insurance coverage, but the law has also been a financial burden for many insurers. Nearly all insurers providing coverage throughout the country are raising premiums on the policies they offer in order to recover from the financial losses they are experiencing.

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