Health Insurance Refunds by State

New rules created by the Affordable Care Act require health insurers to spend on average at least 80% of premiums on actual medical care instead of overhead and profits. Miss the mark and insurers have to refund customers.

Early data released by insurers helped us determine which insurance companies will owe rebates in your state. Rebates will vary in size, but for the first time ever, insurers are actually giving you money back, and anything helps!

Rebates depend on how you get your coverage: whether you buy it on your own or for your family, get it through a small business (50 or fewer employees), or through a large employer with more than 50 employees. Public programs like Medicare and Medicaid spend relatively little on administrative costs and are not included in the refund rule. Medicare Advantage and Medicare supplemental policies have to abide by separate standards but do not owe rebates to customers at this time.

Final numbers are still pending release later this summer but refunds are due by August 1.

Here are the insurance companies in Oregon that are expecting to owe rebates.

Individual Market

  • Time Ins Co: $1,990,950.00
  • Mega Life & Hlth Ins Co The: $620,534.00
  • Total: $2,611,484.00

Small Employer Market

  • LifeWise Hlth Plan of OR Inc: $1,266,309.00
  • Total: $1,266,309.00