Beet
Atlas Star
Posts: 28,931
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« on: July 25, 2012, 10:09:38 PM » |
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Dear Beet,
This latter is to inform you that CareFirst BlueChoice, Inc. will be rebating a portion of your health insurance premiums. This rebate is required by the Affordable Care Act - the health reform law.
The Affordable Care Act requires CareFirst to rebate part of the premiums it received if it doe snot spend at least 80 percent of the premiums CareFirst receives on health care services, such as doctors and hospital bills, and activities to improve health care quality, such as efforts to improve patient safety. No more than 20 percent of the premiums may be spent on administrative costs...
...In your employer's State, Virginia, CareFirst did not meet the 80/20 standard....CareFirst must rebate 2.1% of the total health insurance premiums paid by the employer and employees of your group health plan. We must send this rebate to your employer or group policyholder by August 1, 2012....
If your group health plan is a non-Federal governmental plan, the employer or group policyholder must distribute the rebate in one of two ways:
* Reducing the premium for the upcoming year; or
* Providing a cash rebate to employees or subscribers that were covered by the health insurance on which the rebate is based.
If your group health plan is a church plan, the employer or group policyholder has agreed to distribute the portion of the rebate that is based on the total amount all of the employees contributes to the health insurance premium in one of the ways discussed in the prior paragraph.
If your group health plan is not a governmental plan or church plan, it is likely subject to the Federal Employee Retirement Income Security Income Act of 1974 (ERISA). Under ERISA, the employer of the administrator of the group health plan may have fiduciary responsibilities regarding use of the Medical Loss Ratio rebates...
Sincerely,
Steve Margolis
Senior Vice-President, Small and Medium Group ASU
CareFirst BlueChoice, Inc.
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My employer is a small business, which likely falls into the last category. Regardless, this appears to benefit my employer and/or me, at the cost of CareFirst.
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