The U.S. Health and Human Services Department today rejected Texas' effort to phase in federal standards requiring insurers selling health insurance to individuals to pay at least 80 percent of premiums in medical-related expenses.
Gary Cohen, director of oversight for HHS, said today that the new standard, part of the Affordable Care Act, will not destabilize the state's market for individual, which he termed "very robust."As a result of the decision, Texans who purchased those policies last year will receive $160 million in total rebates from the 22 insurers who did not meet that standard. A dozen of the 34 insurers active in the state met or exceeded the 80 percent threshold.The new standard, called the medical loss ratio 80/20 rule, went into effect Jan. 1, 2011. The rebates, which apply to policies sold last year, are payable in August, said CohenThe largest rebate, $89.6 million, will come from Blue Cross Blue Shield, by far the largest writer of individual health policies with about 55 percent of the market. That rebate comes to an average of about $220 for each of the insurer's 407,187 covered lives.Cohen said HHS has now denied nine states' requests for a waiver from the rule, while at least partly granting six. Two others are pending.Jim Fuquay, 817-390-7552Twitter: @jimfuquayHave more to add? News tip? Tell us
