Health insurance regulators in North Carolina have identified nearly $156 million in refunds owed to Blue Cross policyholders because of changes coming under the nation's new health law.
Consumers with policies at other companies across the nation also may deserve refunds, says North Carolina Insurance Commissioner Wayne Goodwin. He plans to urge other states to probe potential overcharging for a type of reserve fund.
It turns out that in reviewing Blue Cross' rate increase requests, regulators in North Carolina ran across a peculiar phenomenon: Blue Cross was putting parts of those premiums aside to pay benefits beyond 2014. 2014, as you know, is when the health insurance exchanges open and a slew of changes go into effect that essentially outlaws the worst practices of the industry, like pre-existing condition exclusions, annual benefit caps, and minimum coverage requirements. So the current individual plans - which almost all include a pre-existing condition exclusion - will no longer be in effect in 2014, making setting aside money to pay claims under those plans one of those "accounting errors" the insurance companies just have no idea where it came from.
Your state's insurance commissioner should be expecting a call from NC Insurance Commissioner Wayne Goodwyn about this. It's quite likely that other states will be able to find the same thing, and if they do, here come the refund checks in those states. If you are so inclined, go ahead and give your state's insurance commissioner a call and tell him/her to follow in Goodwin's footsteps.
Just how much will the refunds be to the average Blue Cross customer in North Carolina? $690 for an average individual policy holder.
Blue Cross has agreed by year's end to send refunds to more than 215,000 North Carolina policyholders with individual plans in force on March 23 — the date the new health law was enacted. The refunds announced Monday will vary depending on premiums paid, but will be worth about a month and a half's premiums. For an average policy holder, that's $690, said Brad Wilson, the insurer's president and CEO.In North Carolina, the average Blue Cross premium for individual policies is $380 a month (i.e. $4,560 a year), which means the one-time $690 check will amount to lowering the premiums, this year, by a whopping 15%. When was the last time your health insurance premium was cut by 15%? Hell when was the last time your health insurance company wrote you a check? Yeah, I can't remember either!
Today, a new day begins with a whole set of new protections for health care consumers. As you read this article, new protections are already in place:
- Insurance companies can no longer deny coverage to children with pre-existing conditions.
- Lifetime limits on your healthbenefits are gone. I repeat, gone. No more.
- Insurance companies can no longer cancel your coverage when you get sick.
- You have gained the right to appeal any denials to an independent reviewer.
- For plan-years beginning now, preventive care must be covered without co-pays or deductibles.
- Your child can stay on your plan until age 26.
- You no longer have to seek prior approval to use the nearest emergency room.
- Women no longer need a referral to see an ob/gyn.
Tthese are not just mere statistics, plans and programs. These things affect the lives of real people in a very real way. Here is a woman in New Hampshire, beating back cancer, telling her story of being able to get insurance through the state's high-risk pool, and in the middle of it, receiving a surprise phone call from President Obama:
If you can't see the video, here's Gail's story:
In March of this year, Gail was diagnosed with high grade non-Hodgkin's lymphoma. She had no health insurance. Thankfully, the Pre-Existing Condition Insurance Plan was established. As a result, Gail now has insurance that will pay for her treatments and is responding very well.As she says, health care reform saved her life.
I also want to share this call made to my favorite liberal talk show host, Randi Rhodes, by Lisa, the mother of a boy who was diagnosed with psychotic depression and bipolar disorder. Their insurance, which she says is is one of the better insurances, covered only 40 sessions per year, which got them to maybe March, says mom. She had been putting $1,300 a month aside for the therapy sessions, and he hadn't been able to go more than twice a week for therapy sessions. The insurance company just took the 40-session cap off as a result of the health care reform bill, and now her son can go as often as he needs. She says the bill just saved her house. Here is the audio, it will touch your heart as a mother's voice chokes up with emotion as she recalls what health care reform has done for her:
Not only can her son now get the therapy he needs, thanks to health care reform, her 23-year old daughter can stay on her health insurance while she's attending college.
There's a story like this one in every state. You can hear these stories and tell yours right on the White House web site.
In the end, this is our contribution, the Democratic contribution, President Obama's contribution. More than all the academic debates, beyond all the nitty gritty of regulations, this is what progress is about. It is about changing one life at a time for the better. It's about getting that little boy the therapy he needs. It's about getting Gail the cancer treatment that will save her life. It's about making sure health insurance is no longer house insurance. It's about forcing insurance companies to issue $690 checks to their consumers whom it will no doubt help in this economy. In the end, it's about people. What health care reform is doing is making lives better for countless Americans already, and this before even more major reforms go into effect and the exchanges start in 2014. This is what progress is about. It's not about leaps. It's about steps in the forward direction.
The Republicans have already declared their intention to outright repeal this significant reform, and if they cannot, to starve it of money to be effective should they take power in Congress. The GOP would see that little boy suffer, and they would let cancer win over Gail's liveliness. The GOP plan, Rep. Alan Grayson was right, the Republican health care plan is this: Don't get sick, and if you get sick, die quickly. We have a clear choice in November. We can get out, work out butts off and make sure that President Obama can continue to implement these reforms with a friendly, rather than a hostile Congress. Or we can pout over our various grievances and watch our fellow Americans' lives jeopardized by the Tea Party Republicans. We can - and must - make the choice to keep moving forward.