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How can I find if I'm getting a rebate on my health-insurance premium?

Consumer Reports News: July 13, 2012 10:38 AM

Q. Who gets a rebate from insurance companies and what companies give it? I haven't been able to find out.

A. Good news: As of this morning, there's a new tool from the Department of Health and Human Services to help you look up the answer. And if you're just catching up on this new benefit from the Affordable Care Act, here's some background.

On Aug. 1, nearly 13 million Americans are in line to collect a grand total of more than $1.1 billion in rebates from insurance companies who collected more premiums than they needed to pay for their members' health care and health improvement activities.

In the new tool, just scroll down to the state you live in, start typing the name of your insurance company, and select from the choices you see.

For instance, Connecticut residents with Aetna insurance will learn that the average subscriber to an individual plan will get a $151 rebate later this summer, because the company only spent 75.6 percent of its premium dollars on health care and health improvement, instead of the required 80 percent. However, people in large or small group Aetna plans in Connecticut won't see rebates, because those plans actually spent more than the minimum on health care.

"We're very excited about this tool," says Teresa Miller, acting director of oversight at the Center for Consumer Information and Insurance Oversight, the federal agency running health reform. "It's important for consumers to know it's just an average, and they might see the rebate in a number of different ways, such as a check in the mail, a lump sum reimbursement to your credit card, or a direct reduction in your future premiums."

In general, Miller says, your rebate will be in proportion to the size of your premium, and if you split the premium with your employer, you'll share the rebate in the same proportion.

Another caveat: If you work for a larger employer that self-insures, meaning the company pays its employees' health expenses out of its own funds, the rebates don't apply to you. You can't tell from your insurance card whether your employer self-insures; the only way to know for sure is to ask your human resources department.

DeAnn Friedholm, health reform campaign director for Consumers Union, Consumer Reports' advocacy arm, said the new lookup tool "is an important step toward empowering consumers with useful information to get the best value for their health-care dollar."

For more details, see our Health Insurance Buying Guide.

Got a question for me? Ask it here.

Nancy Metcalf

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