Nearly 193,000 North Carolina customers are getting rebates averaging $87 this summer because their health insurance company could not keep overhead costs down, the U.S. Health and Human Services Department said Thursday.
The money goes to consumers whose health insurer failed in 2012 to meet a benchmark requiring that 80 percent of each premium dollar to go toward medical services and less toward overhead and bonuses.
Insurers are required by the federal health overhaul law to limit profits, salaries, and other administrative costs to no more than 20 percent of premiums. Those that do not must rebate their customers either with a check in the mail, a reimbursement to their credit or debit card, or premium reduction.
The federal agency did not make available on its web site individual insurance company reports due by June 1 that would show which exceeded the 20 percent threshold the most. Those reports will be available later this summer, spokeswoman Alicia Hartinger said.
This is the first time North Carolina residents will receive the "medical-loss ratio" rebates.
Federal regulators last year allowed North Carolina insurers a one-year delay in meeting the benchmark because the state's highly concentrated market of just nine insurers needed some leeway to keep from driving some out of the state. Blue Cross Blue Shield of North Carolina had more than 80 percent of the market for coverage sold to individuals and small businesses, the federal agency said last year.
Blue Cross customers likely would not be eligible for rebates on their 2012 premiums because it said it exceeded the 80 percent standard.