Did you recieve a rebate check from your group health insurance company? This check was sent to you by the health insurance company in accordance with the Patient Protection and Affordable Care Act (PPACA), also referred to as health care reform.
What is this rebate for?
As part of the 2010 Health Care Reform legislation, insurers are required to issue rebates if certain federally mandated criteria are not met. For more information, please refer to the Health and Human Services (HHS) website (http://www.healthcare.gov/law/index.html)
Why was this rebate information sent in more than one mailing?
Some of the regulations and guidance about health care reform was issued later than anticipated. Humana is required by law to send both 1) a check and 2) a government prescribed notification to policyholders who will receive rebates. The fastest and simplest way to comply with this requirement was to send the notification separately from the check.
What is the 85/15 rule?
The 85/15 rule refers the ratio of the amount of premiums that an insurer collects to the amount it spends on claims. Under the PPACA, insurers are obligated to spend a minimum amount of the premium collected on medical claims or towards activities that improve health. In the case of the 85/15 rule, an insurer must spend 85% of the premium collected on medical claims on health improvement activities.
How will we know if we are eligible for a rebate? Does our group have to do anything to
receive our rebate?
Rebate checks are automatically sent to groups and subscribers who are owed rebates.