Bait and rebate

CFI Care (not its real initials) sent me a form letter to tell me that they would not be sending me a check:

The Affordable Care Act requires health insurers in the individual and small group market to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality (in the large group market, this amount is 85 percent). This is referred to at the Medical Loss Ratio (MLR) rule or the 80/20 rule. If a health insurer does not spend at least 80 percent of the premiums it receives on health care services and activities to improve health care quality, the insurer must rebate the difference.

It would be nice if, the Federal site that details some of these factoids, had actually posted a list of insurers and the MLR for each. (If in fact they do, I apologize, but they need to do a better job of spelling out where it is.) Still, it was no particular trick to find the pertinent number for my own carrier: 86.

Inasmuch as the line before the quoted text says flatly “You will not be receiving a rebate,” I suspect some people heard about this on “the news” (as distinguished from the news) and just naturally assumed they’d be getting a check, which presumably they could use to buy a free lunch. did provide a breakdown at the state level. Apparently nobody at all in New Mexico will be receiving a rebate.


  1. John Sauler »

    8 September 2012 · 6:08 pm

    We got a letter as well, but ours was good news. The bad news is that they were sending our company 1 check, with no inclination of how those funds are supposed to be divided between employees or the employer that pays a portion of our spouses and dependents premiums. It is a cluster f$&k.

  2. Mark Alger »

    8 September 2012 · 8:13 pm

    I’m sorry. Why should I give 20% of my health care dollars to an insurance company which does NOTHING to improve the quality or delivery of my medical care?

    I think there needs to be some remedial math lessons out there.

    Wake up, people! You’re being fleeced by a special interest that is in bed with statists at the Federal level. Pay cash for services. Sock that 20% away for a rainy day and you don’t NEED insurance. AND, as a bonus, the prices you pay for medical goods and services will go DOWN.

    And do it fast, before the advent of socialized medicine (and this time, we MEAN it!) makes it impossible, because there are no more independent medical practitioners.


  3. CGHill »

    8 September 2012 · 8:27 pm

    Well, there’s this one, complete with online price list.

  4. Brian J. »

    9 September 2012 · 5:31 am

    My refund check was less than the quarterly increase in my premiums.

    Kinda like the Bush stimulus check was less than my quarterly estimated tax payments, which I had to write in the same month.

    The chicanery only works if you’re not paying attention and you work for someone else.

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    9 September 2012 · 5:35 am

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