You trust us to provide good value for your health insurance, and we strive to be efficient stewards of your and your employees’ health care dollar. Our communities have faced significant challenges because of the pandemic, and members have paid for coverage for care they have not been able to fully access because of stay-at-home orders or other precautions.
To support our communities during the economic hardship from the pandemic, we are issuing a credit totaling about $1.4 million to our customers (about 15% of one month of premium). The credit will apply on October bills for fully insured groups.
While we are pleased to offer some relief now, we also want to acknowledge that the long-term impact of COVID-19 on insurers, employers and members remains uncertain. We will continue to maintain our long-term financial stability so we can pay members' claims, both for COVID-19 today as well as for other critical care in the future.
Detail on how the credit will apply by LOB:
Washington: October bills
- Fully insured groups
- Credit for large groups will apply to insured medical, dental and vision premium
- Credit for small groups will apply to insured medical premium (excludes premium for insured dental and vision)
Why are you crediting my bill?
We know that during the peak of community restrictions during the pandemic, our members may not have been able to fully access care for which they had coverage. We want to credit customers a percentage of their premium, corresponding with an estimate of deferred care during the pandemic.
Why only one month?
This one-time credit of a percentage of one month’s premium corresponds with an estimate of the cost of care we believe went unused during community orders and restrictions and will not return.
How did you determine this amount?
This one-time credit corresponds with the cost of care we believe went unused during the shutdown and will not return.
How much will my credit be?
Credits will be calculated as about 15 percent of one-month’s premium, applied to October billed amounts using the enrollment on the bill at that time.
When will I see the credit on my bill?
The credits will apply on October bills, which typically are issued beginning in early September.
How will it appear on my account?
The credit will appear as a separate line item: “Amount due shows one-time premium credit as a result of COVID.”
What if I pay premium quarterly?
If you pay your premium quarterly, you will still receive a 15% credit based on one month’s premium and the credit will appear on your next bill.
What if I pay premium annually?
If you pay your premium annually, you will still receive a 15% credit based on one month’s premium and it will be credited on your next bill if your next billing will occur in 2020, otherwise it will be distributed by check mailed to you in September.
Does this include premium only or the other fees I pay?
The credit will apply only to premium amounts.
What if my account has a credit balance?
Eligible groups with a credit balance will receive the credit based on their monthly premium.
What if my account is delinquent?
Eligible groups whose accounts are delinquent will receive the credit; however, the credit will be withdrawn if payment is not ultimately made. Groups must be effective through the October billing cycle.
Note: Groups that have or will receive final bills may not be eligible for the credit.
I had to defer very expensive care that is no longer necessary. Can I get a credit of more than 15 percent with proof?
No. It is not feasible to evaluate every member’s or group’s unique circumstances and provide a customized credit nor has an alternate approach been approved by regulators.
What if I have added or lost employees since the date the credit is based on?
The credit will be calculated based on the premium paid for September 2020 coverage. Changes to a group’s credits will not be adjusted, whether up or down, to account for new or departing employees.
Are there minimum credit amounts?
The minimum amount for a group customer is $20; if the calculated credit is less than $20, there will be no credit issued. This minimum amount matches the standard minimum for MLR rebates.
Note: If a group has subgroups and at least one subgroup reaches the $20 threshold, all subgroups will receive the credit.
My group health insurance takes effect Sept. 1. Do I get this credit?
Groups that begin coverage effective Sept. 1 are not eligible for a credit. The one-time credit corresponds with the cost of care we believe went unused during the COVID-related shutdown. Because coverage was not in place at that time, the credit would not apply.
I signed up for health insurance after Aug. 3, but it took effect Aug. 1, can I get the credit?
Groups whose coverage takes effect in August, retroactively to Aug. 1 are not eligible for a credit. This one-time credit corresponds with the cost of care we believe went unused during the COVID-related shutdown and will not return. Because coverage was not in place at that time, the credit would not apply.