Employers expected to receive millions in health insurance rebates
By August 2012, U.S. businesses that sponsor fully insured group health plans could share millions of dollars in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Patient Protection and Affordable Care Act (PPACA), finds an analysis from the not-for-profit Kaiser Family Foundation.
The PPACA requires insurance plans to pay out a minimum percentage of premium dollars toward health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at least 85% of premium dollars on health care and quality improvement, while small group plans must spend at least 80%. These percentages are known as the medical loss ratio (MLR). If an insurer fails to meet the MLR within a market segment in a state, it must issue a refund to consumers and employers. For group plans governed by the Employee Retirement Income Security Act (ERISA), insurers generally will provide rebate amounts to the group policyholder, which often will be an employer or plan established by an employer. Self-funded plans are not subject to the MLR regulations.
The Kaiser Family Foundation report, "Insurer Rebates under the Medical Loss Ratio: 2012 Estimates", finds that estimated rebates include $541 million in the large employer market, $377 million in the small business market and $426 million for those buying insurance on their own.
Among employers, 28% of the small group market and 19% of the large group market are projected to receive rebates.
The largest rebates overall are projected to go to consumers and businesses in Texas (total $186 million) and Florida ($149 million); Hawaii is the only state where no insurer is expected to issue a rebate.
The data for the insurance rebates are based on estimates provided by insurers in filings to the National Association of Insurance Commissioners in 2011. Actual rebates will be based on reports insurers submit to the federal government in 2012.
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HCN selects state-by-state Hardware Store All-Stars
The 2012 crop of Home Channel News Hardware Store All-Stars marks the second year of the state-by-state accounting of high-performance retailers. The common theme of “excellent customer service” runs through the entire list, but that’s just the beginning.
Here are the honorees from Connecticut, Delaware and Florida:
Washington Supply Co.
Washington Depot, Conn.
Visitors to Washington Supply Co. can monitor the operation’s energy generation and consumption in real time using a 32-in. touchscreen display in the front of the store. Or they can watch the building’s solar photovoltaic system do its thing by clicking a link on the retailer’s website. The $50,000 investment, now 2 years old, generates about one-third of the home center’s energy needs. But the PV system has also drawn visiting dignitaries, eco-tourists and customers interested in buying installed solar panels. It’s positioned Washington Supply as the place to go for green products and building materials in western Connecticut.
Best Ace Hardware
Best Ace hardware has grown from its general store roots to a chain of five Delaware hardware stores with strong niches in lawn and garden and wild bird. So strong, in fact, that the stores offer their own custom-mixed bird seed, Tom Best’s Choice. An emergency roof repair project in 2010 forced the company to rethink its design. “The silver lining was we tried some new things, and we’ve enjoyed success,” said Andrew Best, great-grandson of the founder.
When owner Bill Pastermack first brought fishing equipment into his store on Florida’s space coast, the idea was to take advantage of wholesale pricing for his own excursions. His passion for fishing has helped create a destination niche for sportsmen as far away as Orlando. Fishing for niches such as pet, paint and even sunglasses is a passion for Ace Hardware of Titusville. The latest: a standalone surf shop called Go Native.