Some Anthem customers to get rebates

BY JIM HALL

Thousands of Anthem customers could get rebate checks next month, thanks to a provision in the federal health care reform law.

C. Burke King, president of Anthem Blue Cross and Blue Shield, said Tuesday that the state’s largest health insurer is prepared to issue premium refunds in July.

The refunds will average $10 each for those with individual health insurance policies from Anthem. More than 176,000 people have purchased this type of policy, said company spokesman Scott Golden.

For employers with small-group policies, the refunds will average $800, King said.

The small-group plans are sold to companies with 50 or fewer employees. These companies have 84,000 subscribers, Golden said.

The rebates will go directly to the companies, King said. The companies will be asked to share the money with their employees, based on how much of the premiums that the employees paid.

Large-group plans, or those purchased by companies with 51 or more employees, will not  get  rebates, nor will self-insured companies, or those that hire Anthem to administer their health plans, King said.

King was in Fredericksburg Tuesday night to speak to the Rappahannock Area Business Leadership Forum.

His appearance came as the U.S. Supreme Court weighs the constitutionality of the 2010 Affordable Care Act, the federal health care reform legislation. The court’s decision is expected by the end of the month.

King declined to predict if the Supreme Court would reject some or all of the law.

“I’m not taking sides,” he said. “It truly is 50–50.”

If the law survives, Anthem will be required to send out rebates to thousands of its customers under the new “medical loss ratio” provision.

The law says that health insurance companies must spend certain minimum amounts of their revenue from premiums on health care and quality improvement, rather than administration and profits.

This portion of the law took effect Jan. 1, 2011. Firms that do not meet the required minimums must send out refund checks by Aug. 1 of this year.

The law sets the minimum health care expenditures at 85 percent for large-employer plans, and at 80 percent for individual and small-employer plans.

For Anthem, the refunds will total .4 percent of the premiums collected, Golden said. He declined to say how much that is.

Golden said it’s not clear what will happen to the rebate payments if the Supreme Court strikes down portions of the law.

“As of right now, we’re fully prepared to send these out,” he said.

On another issue, King said Anthem has not decided whether to join its competitors and retain some aspects of the Affordable Care Act, even if the law is ruled invalid.

UnitedHealthcare, Humana and Aetna said this week that they will continue to offer some of the initial provisions of the law, regardless of what the Supreme Court does.

The companies said they would continue to cover preventive care without charging a co-payment, and they would continue to offer dependent coverage to adult children up to age 26.

United and Humana also said they won’t impose lifetime limits on how much they pay out to cover claims, and they will not cancel a person’s coverage retroactively, except in cases of fraud.

“Our plan is when we see what is struck down and what is not, then we will decide what aspec

ts we will still move forward with and which ones we won’t,” King said.

He added, “There are some aspects of the law that we as a company might want to keep in place, like covering kids up to age 26. We need to have a dialogue with our customers to make sure that’s what they believe.”

Jim Hall: 540/374-5433

jhall@freelancestar.com

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