Otolaryngology Coding Alert

Biggest money expected in Texas and Florida.

A new analysis from the Kaiser Family Foundation shows that consumers and businesses are expected to receive an estimated $1.3 billion in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Affordable Care Act (ACA). The rebates are expected by August 2013, with figures based on the latest estimates that insurers provide to state insurance commissioners.

Totals: Expected rebates include $541 million in the large employer market, $377 million in the small business market, and $426 million for those buying insurance on their own. Most group market rebates will be provided to employers, although monies also could be passed along to employees in some cases.

“This study shows that asking insurance companies to put more of their premium dollar towards patient care rather than administration and profits is not only popular but also effective,” Kaiser President and CEO Drew Altman said in a prepared statement. “There are tangible benefits to consumers and employers.”

The largest rebates are projected to go to consumers and businesses in Texas (with a total of $186 million) and Florida (with $149 million). The only state where no insurer is expected to issue a rebate is Hawaii.

Resource: Read the press release from The Kaiser Family Foundation by visiting www.kff.org and clicking on “Newsroom,” then “The Latest Releases.”