These letters/rebates from Health Insurers are fascinating

[cthulu2016]

Anybody who gets a big rebate... the insurance company is essentially saying, "Yeah, that's right... we have been ripping everyone off for years!"

I assume many (most) folks do not get a rebate. I didn't, and was not surprised.

But either way it's cool to get a letter from your insurer admitting that there is a limit to how much they can charge or how little they can pay.

[Texasgal]

1. I'm still trying to figure out

how the rebates work.

All I know is that there are some people that got rebates. Why? I have no idea.

Can someone help me out?

[cthulu2016]

2. Under Obamacare your insurer is required to pay out 80% of the premiums in benefits.

If they only paid out, say, 70% last year then they are required to refund the 10% difference to their policy holders.

Mine paid out more than 80% so all I got was a letter saying, "We paid out more than 80%."

In theory, I would think that the most over-priced insurers would have to pay out rebates. Presumably they will either be more liberal in paying benefits, or lower premiums in the future. Or they can continue charging a lot or paying out little, but pay out the rebates every year.

(I don't know if they get the "float" on the money... maybe they prefer to pay out the rebates.)

I assume most rebates will go to employers... I think it goes to whoever pays the premiums.

[OffWithTheirHeads]

4. I'll say this again. Your employer in the private sector DOES NOT PAY FOR SHIT!

You, the employee, either directly or indirectly produce enough revenue to pay yourself, the cost of any and all benifits you recieve, your unemployment and workers comp costs, your social security costs AND a profit for your employer or you are dismissed. It's called Capitalisim and it sucks but people need to stop believing the lie that "your employer" does anything from the goodness of his heart other than profit from your labor.

Also, if any of those costs of doing business are somehow lowered, don't expect to see it on your paycheck.

[cthulu2016]

5. Of course benefits are your pay

I am talking about the practical real-world dispersal of checks this year, not what is equitable.

Of course any savings should go to the employees.

[Ruby the Liberal]

3. If you are on an employer plan

The rebate could be a check to the employer, or used as a credit to lower premiums for the next plan year.

If you have your own plan, the check comes directly to you.

Small employers and individual plans get anything over 80% that wasn't used for care, and large employers get back anything over 85%.