BlueCross Bluesheild of Tennessee, the Chattanoooga office seen here, expects to refund some of the increased premiums it charged nearly 90,000 individual plan members last year due to new requirements of the health care reform law adopted two years ago.
Tennessee’s biggest health insurer expects to refund some of the increased premiums it charged nearly 90,000 individual plan members last year because of new requirements of the health care reform law.
In annual filings with state regulators last month, BlueCross BlueShield of Tennessee estimates it may have to refund up to $13.5 million. That’s because, under new federal standards, it didn’t pay out enough of a record $5.1 billion in premium income to medical providers from its individual plans.
BlueCross is expected to mail refund checks in August for individual policyholders, although the actual eventual refund is expected to be less than $10 million.
Most of its 3.1 million members won’t be getting the refunds, however, since BlueCross appears to have met the new medical pay-out requirement for small and large employer groups, spokeswoman Mary Danielson said.
Under health care reform, insurers must pay at least 80 percent of premiums to medical providers for individual and small group plans. The figure is 85 percent for providers to large employer groups. Any shortfall must be refunded to customers by Aug. 1.