The Commonwealth Fund released a study recently that determines that consumers would have received rebates of nearly $2 billion if PPACA’s minimum medical loss ratio (MLR) provision were in force for 2010.
The minimum MLR requirement, which kicks in for the 2011 calendar year, calls for rebates back to consumers if plans’ individual and small group MLRs are below 80% and if large group MLRs are below 85%. The medical loss calculation includes typical medical claims and quality spending, but excludes almost all administrative spending. A Medicare Advantage Part C minimum MLR of 85% comes into force in 2014.
It is unclear if the $2 billion figure will hold for 2011. 2011 rebate checks are due to eligible members in August. Commonwealth says that a quarter of consumers would have received rebates in 2010, with 50% of those with individual coverage receiving a rebate. Rebates would have been on average between $100 to $300 per member.
Residents in Texas and Florida would have received over $200 million.