AUGUSTA – The Bureau of Insurance announced Monday that Aetna Life Insurance Co., an insurer of Preferred Provider Organization plans in Maine, will refund approximately $6.6 million to small employers as a result of Dirigo Health’s rate regulation in the small group health insurance market. The refund represents a portion of the premium paid by small employers from July 1, 2004, through June 30, 2007.
“The law establishing Dirigo Health gives insurers of small groups the option to either submit rates for prior approval or guarantee that at least 78 percent of premiums collected will be paid out in claims,” said acting Insurance Superintendent Eric Cioppa. “Insurers must review premiums and related medical costs on a rolling 36-month time frame. Those who choose the guarantee option and find they do not meet the targeted 78 percent must refund the difference to employers.”
“This is good news for Maine’s small employers,” said Trish Riley, director of the Governor’s Office of Health Policy and Finance. “I see this as an important first step in the broader Dirigo reforms to control the amount of money paid for health care, and we must continue our work to rein in costs that make health care coverage unaffordable to too many.”
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