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A study by the Kaiser Family Foundation revealed that private health insurance companies must distribute $ 2.1 billion in reimbursements to more than 10, 7 million insured for this fall .
According to the organization, reimbursements will be granted after some insurance companies failed to meet the threshold of the medical loss ratio under the Affordable Care Act (ACA), also known as Obamacare , at 2020.
In agreement With ACA guidelines, insurers must spend at least the 80% of premium income from health care claims or quality improvement activities. In 2020, some companies did not reach their threshold because health spending decreased during the pandemic .
What happened has to do with the actions that health care providers took to cancel routine check-ups to avoid visits to the medical office within the framework of social distancing caused by Covid – 19.
This happened in part because providers canceled elective procedures and consumers decided to waive the routine care to prevent possible exposure in the doctor’s office .
Despite this situation, citizens continued to pay their fees, which resulted in higher levels of earnings for the the pandemic will arrive .
According to the study from the Kaiser Family Foundation of the resources to be awarded, not all policyholders will receive a cash reimbursement and the amount provided may vary depending on the insurer.
In this regard , the organization revealed that most of the budget to be reimbursed is around $ 1.5 billion dollars , of which will be destined for five million insured individually.
Additionally, small and large group insurers are projected to receive $ 308 million and $ 310 million in refunds, respectively. These numbers are preliminary estimates, final figures will be released by the end of the year.
The Kaiser Family Foundation was able to make such projections based on data reported by insurers a the Centers for Medicare and Medicaid Services.
According to Yahoo Finance, calculating returns must take into account the premium income that insurance companies allocate to health care expenses and quality improvement.
In addition, it should not be forgotten that insurers take into account a period of three years to obtain their figures reimbursements, which means that this year’s number is not necessarily linked to the issue of the pandemic.
Under this parameter, a significant part of this year’s reimbursements is due to the profits that the insurers earned in 2018 Y 2019.
If you have a link with an insurer and you think they should make a refund We suggest that you contact her and determine your situation to know exactly what is the amount that would correspond to you .
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