June 18, 2013
The Medical Loss Ratio (MLR) standard of the Affordable Care Act requires health insurance companies to devote 80 or 85% of the premiums they collect to provide health care services to customers, after subtracting taxes and regulatory fees. If an insurer does not meet the MLR standards, it may pay rebates to its customers.
As a result of, among other things, strong expense management, collaboration with providers, and business innovations, Blue Cross and Blue Shield of Texas (BCBSTX), a division of Health Care Service Corporation, met or exceeded the MLR standards for the vast majority of our customers in 2012.
Some individuals who purchase insurance policies through the individual, under 65, market segment will receive a rebate and will receive notification as to the exact amount of any rebate. For those few customers that will receive rebates, at this time, we anticipate the one-time rebate for 2012 may range anywhere from $5 to possibly a few hundred dollars this year. Given the inherently unpredictable nature of health care costs and utilization, it is not surprising that health plans may pay rebates to some customers in certain markets.
BCBSTX is part of a customer-owned organization that reinvests earnings to benefit the health and wellness of its policyholders. We set our sights on meeting the health care needs of our customers and facilitating their use of the health care system.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
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