So, if they bring in $100M in premiums & only pay out $75M in claims, they have to rebate $5M. 2/
Individual market enrollees of Blue Cross should keep an eye out next year, however.
⚠️ IMPORTANT: THIS IS BY NO MEANS GUARANTEED. They might not have to pay back a dime.
My projections for the *2019* MLR rebates (which will go out *next* August/September) are VERY crude and may be missing some critical wonky data like Risk Adjustment transfers, etc. Please consider them *guidelines only*.
OK, moving on…
Keep an eye on Highmark next year, however…they hovered around the 80% threshold in 2017 & 2018.
DC’s *total* Lg. Group plan enrollment is nearly as large as their total population. Huh.
Keep an eye on BCBSSC next year, though!
NEXT year, however, could be VERY different: Up to $40 million:
378 individual market enrollees should get…$22,400.
Keep an eye on BCBS of Michigan/Blue Care Network next year!
(This data *was* an ACASignups exclusive at the time I posted it…)
Individual Market? Just $83,000.
First, large group policyholders will receive $24 million in rebates; on the individual market, it’s just $87,000.
(This year, the only reason those 60,000 NY residents are getting their $1.46 apiece is due to the extra 2% threshold.)
Keep an eye on Buckeye Community next year!
Industry-wide? $16 million.
That means each recipient will get over $200 on average.
Industry-wide total: $19.5 million.
Grand total: $19.4 million
Industry-wide total: $16.2 million.
Yep, that’s *$580* apiece on average.
It’s being divided among 580,000 people, however, so the per-person average is just $36.
Group market rebates bring the total to over $107 million, though.
IF ACCURATE, however…HOLY CRAP: $25.5 million being paid out to just 17,000 enrollees…for a per-person average of $1,476!
There’s something else VERY important here, however…
That’s right…health insurers have to operate on a 12% *gross* margin (vs. the ACA’s 20%).
And yet MA still has the *lowest* ACA exchange premiums of any state!
MA seems to counter this claim completely??
$50 MILLION to 56,000 people…for a per-person average rebate of $889 apiece!!
More stunning: HMO Minnesota enrollees will avg. $1,523, proving Kansas’ numbers could be real.
BlueCross BlueShield of TN and Cigna Health & Life are paying out nearly $57 million to 174,000 enrollees.
At $69.5 million, the Keystone State doesn’t have the highest *total* 2018 Indy Market rebates (it’s in 4th place), but check out HMO of NE PA’s per-enrollee average.
Go ahead, I’ll wait.
Not only is HCSC (Blue Cross Blue Shield of TX) paying out $75 million in rebates (the total w/other carriers is $80.3 million), check out the POTENTIAL rebates *next* year.
$92.3 million from Health Net of AZ, or $959/enrollee
You’re reading that correctly: Optima Health Plan has to pay back nearly $99 MILLION in excess premiums to their 57,000 enrollees.
That’s an AVERAGE of $1,739 apiece.
This is no coincidence.
This left them with a 64% 3-year average MLR…thus, they have to pay $99 million back.
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