Health insurer refunds may stall in employers' hands
Source: NBC
It was the great health insurance giveback: $1.1 billion in premiums returned to policyholders under the Affordable Care Act. But while many people who buy their own insurance found a check in the mail last week, millions insured through employers are still wondering what is happening with the money.
Workers were notified in form letters from insurers this month that a rebate had been sent to their employer, who must follow certain rules in distributing the rebate to you. But even when employees paid a significant share of the premium, many employers are still deciding how, when or even whether to share the cash.
Calls are now pouring into human resources departments around the country, said Mendy Stein, a health benefits specialist with Mercer, a nationwide consulting firm.
Were seeing a very high increase in the number of calls that H.R. call centers are handling from employees saying, Wheres my money? he said.
Read more: http://www.msnbc.msn.com/id/48604645/ns/us_news-the_new_york_times/?__utma=14933801.1103610280.1344517666.1344554074.1344578060.4&__utmb=14933801.1.10.1344578060&__utmc=14933801&__utmx=-&__utmz=14933801.
Indeed, so the companies are hogging the cash?
jberryhill
(62,444 posts)I would imagine that all kinds of companies are thinking about how they could keep all or a disproportionate share of the rebates. Why would that be limited to "big health companies"?
Bolo Boffin
(23,796 posts)They are still deciding what to do with it. My understanding is that our portion could just be included in our checks (minus the taxes, of course) or it could be applied to future premiums (bumping up the take home pay for a couple of checks). The article says something about wellness programs, but I don't see that happening in my company. I'm sure they will take out their percentage of what they pay, though.
DallasNE
(7,403 posts)Some of the people that overpaid are no longer with the company and others have been with the company for less than a year. There are even those making COBRA payments.
Bolo Boffin
(23,796 posts)Those people no longer with the company need a check cut to them. Working out the mechanics of that and what to do with current employees would take some time. Future premiums could only apply to people on the payroll now that were on the payroll in 2011.
DallasNE
(7,403 posts)But it is complicated because each person picks from a menu of items each year so their coverage changes from year to year as do their premiums.
Hyper_Eye
(675 posts)What they are saying is that when health insurance is obtained through an employer the rebate checks are sent to that employer. It is then up to the employer to provide the rebates to their employees. I think the issue is that premiums paid through an employer are often split between the employer and the employee and so part of the rebate would be kept by the employer. Say you work for a company that pays 70% of the health insurance premium while the employee pays 30%. The employer might keep 70% of the rebate and provide the employee with the remainder. That seems reasonable to me. In my case I work for a company that pays 100% of our health insurance premiums. Were me health insurance provider to provide a rebate on our premiums (which they will not be because they exceeded the requirements set by the ACA) I would expect my employer to keep all of it. I didn't pay any premiums so there is no reason why I should get a premium rebate. The problem that is being reported is that many employers are failing to distribute the rebates to their employees even though their employees pay a portion of their health insurance premiums. The employers are just keeping the full rebates for themselves.
This has nothing to do with the health insurance companies. They would be in a lot of trouble if they weren't sending the rebates as required by the health care law. This is an issue with the employers that are sitting between the health insurance companies and people who should have received a rebate on the premiums they paid.
Rosa Luxemburg
(28,627 posts)snot
(10,538 posts)It seems to me an argument could be made that all of the refund should go to the employee, since all of the insurance is basically part of her/his compensation package, part of what the employer had agreed to pay in order to retain the individual as an employee.
Hyper_Eye
(675 posts)You could say that the customer agreed to pay all of the premiums charged to receive health insurance coverage from a health insurance provider. The problem with that is the insurance companies charge premiums well beyond what is required to provide quality health care to their customers. When they are all doing it that leaves the customer with no suitable alternative because going without health insurance is not a real alternative at all.
When it comes to what the employer agreed to pay the employee to retain that individual, they agreed to provide the employee with a certain level of health coverage. That is a separate issue from what the cost of that coverage is. As premiums rise and fall the cost of that coverage will change for the employer but that is irrelevant to the coverage that is being provided to the employee. If rebates are being sent out because premiums were higher than necessary to provide coverage, as required by the law, then the entity that overpaid on the premiums should be rebated. Employers should not be getting screwed on the cost of providing health insurance to their employees anymore than the employees should be getting screwed on the amount of premiums they are paying. Ultimately it is good for employees that the employer receives a rebate on the premiums the employer pays as that makes the coverage more affordable for them to provide and thus those savings could translate into long-term raises or be added to a bonus pool.
docgee
(870 posts)When premiums go up, employees are usually asked to pay more. It is definitely not so clear cut and depends on the company. A little more transparency is necessary on the company's side. I'm lucky, on my paycheck, it's printed how much I pay and how much my employer pays. The employer paid part is definitely part of my compensation. Year to year the prices are locked in with the insurance company, therefore I believe the refund goes to the employee.
snot
(10,538 posts)At the time of the decision to hire or continue to employ the employee, the employer decided, "I'm willing to pay $X to retain this employee." The employer's primary concern is the cost, not whether the insurance is priced fairly. The deal was that whatever the benefits of that $X were to go to the employee.
Of course, the flip side is that the employee was willing to be employed for the coverage actually received, whether overpriced or not.
Clearly, any contribution toward premiums paid by the employee should go back to the employee, bec. that wasn't part of any compensation to the employee for her/his labor; that's not in contention, or shouldn't be.
But ALL of any premium paid by the employer SHOULD be in contention, because it WAS intended by both sides as part of the compensation to the employee, and the parties both intended the employee to receive ALL of the benefits from it.
So at worse, the employee should get half of it; but it still seems to me there's an argument the employee should get all of it.
jberryhill
(62,444 posts)The employer did not include the dollar amount of the premium payment - whether high, low, or indifferent - as a monetary compensation equivalent component of salary.
DallasNE
(7,403 posts)And, quite honestly, it is very complicated although they have had over a year to figure it out. They only way to get the money into the hands of those who were overcharged is with a refund. With different options, major events, people coming and going, etc. there is no easy formula that would be completely fair. So far I have not heard a whisper but then I don't have the data that my insurance company cut a check either.
julian09
(1,435 posts)are required by law to spend 85% of premiums on actual health care. If CEO compensation, advertising, and administration exceeds that 15%, you are not getting what you are paying for and insurance companies have to rebate the difference.
cstanleytech
(26,319 posts)sitting on profits while paying their workers who are struggling low wages (except at the corporate level like CEOs) already so it is anymore shocking to think that they wont try to withhold this money from the workers as well?
Festivito
(13,452 posts)All those complaints of how the prices were going to skyrocket.
JohninPA
(54 posts)And the rebates have been a nightmare. The employers have 90 days to distribute the rebates for those that are wondering. I represent two employers each with about 50 employees on the plan who have recieved the checks. Both checks are for under $150. So the employers had to calculate the distribution among all employees based upon thier participation tier ( single, family, etc). Since the employers both pay 75% of the premium, the employees rebate is further reduced by that 75%. So, the employers HR staff, me their broker/consultant, and the health insurance company ( in this case Coventry) have invested countless hours to refund each employee less than 25 cents.
Health insurance carriers in a competitive market really do keep premiums close to expenses. Any carrier exceeding the MLR (medical loss ratio) rebate threshold will likely only do so by a very small amount. Our local Blue Cross / Blue Shield plans pay out roughly 92 cents in claims for every premium dollar (we have 5 in PA). Coventry is generally in the 85% range. In this case the solution is more of an issue than the problem it was trying to fix. I am not as familiar with some of the Western carriers, maybe they do have a larger profit margin in their operations.
Enrique
(27,461 posts)and by "countless" hours, you actually mean a finite number of hours. I'm sure the companies would rather it cost zero hours, but boo hoo, that's life, they will have to once a year pay a little more for accounting services. If it makes it any easier, they can use computers to help them with the calculations, and software such as Microsoft Excel.
JohninPA
(54 posts)Boo Hoo? I am going to go out on a limb and guess you never had to make payroll? The calculation is easy, but adding it to the payroll system is costly. The cost of one group administering the $124 refund was several thousand dollars between the group, the health insurer and my services. Is this efficient? Boo Hoo indeed. How do you think the additional cost associated with this administrative burden is paid? I'll tell you, increased premiums and added employee contributions to their health insurance.
sarcasmo
(23,968 posts)JohninPA
(54 posts)The places where a health insurance company is legally allowed to place reserves (where this money comes from) is limited. 10 years ago you would have a point. The short term secured investments the reserve is held in return almost no income and often return a loss given the extremely low interest rates today.
I generally don't like to defend insurance companies, but when we try to solve a tough problem with in incorrect or incomplete understanding of the facts, we make things worse. I meet people every day who cannot afford health care. It is heartbreaking. Some parts of the health care reform is very good and will help. Many other parts, such as the MLR rebate are counter productive and waste resources and cause more problems.
just1voice
(1,362 posts)Despite the huge incentives in a for-profit health care system of corruption and decades of proof of how criminal it is.
But hey, let's give them even more money, pass laws that any state can and will easily ignore and hold no one responsible for years of corruption.
underpants
(182,878 posts)aside from this unsurprising news story is that people are actually seeing part of Obamacare (embrace the name) in action.
Rosa Luxemburg
(28,627 posts)and they hadn't heard of this
Ron Obvious
(6,261 posts)Not that I was expecting one.
Am I reading this correctly, or are only people with employer-paid plans eligible? Been paying for over a decade into Regency Blue Shield in Washington State. Did anyone in a similar position get a rebate?