A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
Call our agency partners 855-367-0132
Call our agency partners 855-367-0132
Featured Featured
What are the deadlines for the ACA’s open enrollment period?
A list of the open enrollment deadlines for enrollment in 2023 ACA-compliant health insurance in every state. Open enrollment ended on January 15, 2023 in most states.
Latest News & Topics Latest News & Topics
Featured Featured
Applying for ACA Coverage?
Understanding how small differences in projected income can have a large impact on your health plan costs can be key to obtaining affordable coverage.

ACA’s 2014 medical loss ratio rebates

The Affordable Care Act's '80/20' rule delivered $332 million in premium refunds to 6.8 million Americans in 2013, its second year

The Affordable Care Act's medical loss ratio (MLR) returned $332 million to 6.8 million American consumers in its third year.

The Affordable Care Act’s requirement that health insurance companies spend 80 percent of your premium dollars on actual health care – rather than marketing, administrative and CEO salaries – returned $332 million to 6.8 million American consumers in its third year.

The medical loss ratio – also known as the 80/20 rule – means that insurers for the first time have to disclose where they’re spending plan holder premium dollars. If they spend less than 80 percent (less than 85 percent for large group plans) on providing medical care, they must rebate the excess dollars back to consumers each year.

The medical loss ratio has returned billions in health insurance premium rebates to consumers since 2012.

The average American household received $80 in the third year, with the highest rebates in Minnesota ($522), Alaska ($388), New Jersey ($300) and Montana ($286). See the statistics for your state below.

ACA’s 2014 medical loss ratio rebates
State Total Rebates Consumers Benefiting Average per Family
Alaska $3,062,042 11,431 $388
Alabama $990,323 10,342 $111
Arkansas $6,269,271 57,712 $183
Arizona $1,370,182 347,772 51
California $11,902,850 490,052 $39
Colorado $2,721,701 52,277 $93
Connecticut $3,019,862 69,186 $72
District of Columbia $11,411,222 164,503 $149
Delaware $734,278 5,886 $174
Florida $41,679,928 981,273 $65
Georgia $11,141,472 304,940 $53
Hawaii $4,892,872 68,090 $133
Iowa $1,753,306 14,598 $206
Idaho $1,576,721 31,589 $92
Illinois $8,387,603 108,581 $120
Indiana $11,889,719 254,127 $84
Kansas $3,615,148 59,966 $89
Kentucky $6,298,456 209,476 $43
Louisiana $4,947,832 119,720 $71
Massachusetts $15,093,428 208,751 $133
Maryland $17,265,604 206,102 $140
Maine $1,845,006 19,542 $149
Michigan $13,189,718 184,297 $118
Minnesota $523,254 1,915 $522
Missouri $14,609,316 52,661 $66
Mississippi $6,631,232 66,832 $139
Montana $2,719,595 14,170 $286
North Carolina $8,488,477 182,517 $77
North Dakota $68,894 947 $139
Nebraska $1,543, 46,444 $215
New Hampshire $77,507 16,023 $9
New Jersey $7,670,066 44,998 $300
New Mexico $68,528 628 $158
Nevada $4,049,168 74,476 $85
New York $12,147,281 617,465 $138
Ohio $11,331,726 143,327 $37
Oklahoma $6,739,649 89,648 $128
Oregon $3,082,182 49,412 $101
Pennsylvania $5,198,874 90,485 $75
Rhode Island $48,696 710 131
South Carolina $13,187,815 205,229 $92
South Dakota $2,582 867 $5
Tennessee $10,037,932 336,141 $53
Texas 13,690,983 189,005 $114
Utah 3,296,969 104,576 $81
Virginia $8,913,605 104,774 $148
Vermont $0 0 $0
Washington $792,846 9,605 $122
Wisconsin $2,584,967 69,396 $52
West Virginia $902,721 8,290 $177
Wyoming $1,483,884 8,203 $268
Guam $2,502,478 39,670 $107
Northern Mariana Islands $2113,595 1,796 $120
Puerto Rico $3,545,675 76,230 $99
Virgin Islands $0 0 $0

 

sticky-bottom-cta

Get your free quote now through licensed agency partners!