CLEVELAND -- More than 81,000 Ohio families will be getting health insurance rebates this summer that will total $11.3 million across the state, a newspaper reported. The average refund will be $139, but some of the 81,500 families will receive hundreds of dollars more, The Plain Dealer in Cleveland reported.
The Ohio rebates are part of the $1.1 billion that insurers nationwide must return to nearly 12.8 million Americans this year under the Affordable Care Act, according to the U.S. Department of Health and Human Services.
The act requires insurance companies to spend 80 or 85 percent of premiums collected on medical care or care improvements. The remaining 15 or 20 percent can be spent on salaries, advertising and other administrative expense or kept as profit, but anything over that must be returned to customers.
Officials with some companies that owe rebates have said it is difficult to predict the cost of care. Anthem Blue Cross and Blue Shield spokeswoman says individual customers used fewer health care services last year than projected, and the rebate amount is only 0.1 percent of the total premiums Anthem took in last year.
"It's a very small percentage," Anthem spokeswoman Kim Ashley said. Insurance companies must provide their numbers to Health and Human Services, which determines whether they owe rebates and how much.
The new regulation is a critical to ensuring that Americans get the best value out or their insurance coverage, said Teresa Miller, acting director of Health and Human Services' Oversight Group at the Center for Consumer Information and Insurance Oversight.
Millions of people benefit from insurance companies that are meeting the standard, Miller said.
"Instead of paying for advertising or marketing or executive salaries, they can be sure their premiums are paying for their medical care," she said.
No one in Ohio who's covered by a large group plan - a company with 51 or more employees - is due a rebate, according to Health and Human Services.
The Ohio Department of Insurance says about 66 percent of Ohioans insured through employer health plans are in self-funded plans, which are exempt from the regulation.
All insurance companies are required by law to send letters to policyholders no later than Aug. 1 stating whether the company owes a rebate and how much. The deadline for sending the rebates also is Aug. 1.
Companies receiving the rebates must provide them to employees in a timely manner, but they can distribute them as checks to employees, a deduction from next year's premium or as an additional health benefit, according to Health and Human Services.
Those who bought insurance through an individual plan should receive any rebates by check or as a reimbursement to a debit or credit card.
Ohioans who have not received owed rebates by Aug. 1 should contact their employer if they are in a group plan or their insurer if they are in an individual plan, according to Health and Human Services.
The Associated Press