Individual market insurers are estimated to owe about $500 million in rebates to enrollees this year, a Kaiser Family Foundation analysis found. Small group market insurers are anticipated to owe about $330 million, and large group market insurers are expected to owe about $250 million.
In 2021, Medicare Advantage gross margins averaged $1,730, more than double other insurance markets, the Kaiser Family Foundation report found. The individual market’s gross margins averaged $745 per enrollee, group market’s gross margins averaged $689 per enrollee and Medicaid managed care’s gross margins averaged $768 per enrollee.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Insurers that didn’t meet medical loss ratio requirements have paid out a total of $2 billion in rebates to nearly 10 million people, split between people who received their insurance through individual market plans and group plans.
Payers appeared to have a profitable 2020, with gross margins per member per month increasing, and administrative costs and medical loss ratios decreasing, a new report shows. But payers still have to contend with rebates their owe per the ACA medical loss ratio provision, which could amount to more than $2 billion.
Anthem Inc. saw Medicare Advantage enrollment increase more than 20% year-over-year. The company now has a total of 1.2 million members enrolled in Medicare Advantage plans, and expects to add another 150,000 to 200,000 members next year.
Blue Cross & Blue Shield of Florida led the way among the nation’s top insurers that were required to pay the largest refund to policyholders and new enrollees under health reform, with $10.1 million in refunds as of the end of June. That’s according to data compiled by CMS and analyzed by SNL Financial on […]
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.