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June 22nd, 2012
Grijalva Highlights More Than $1 Billion in Rebates Sent From Health Insurers to Americans as Part of Affordable Care Act Assistance

Tucson, Ariz. – Rep. Raúl M. Grijalva today highlighted the approximately $1.1 billion in rebates Americans will receive from insurance companies this summer thanks to the Affordable Care Act’s “80/20 rule,” which requires insurers to spend at least 80 percent of each dollar of consumer premiums on medical care and quality improvement and provide rebates for any excess. Arizona will receive $12,462,960 in individual market rebates, $8,852,429 in small group market rebates, and $6,323,778 in large group market rebates for a total of more than $27.6 million.

“This is money back in Arizonans’ pockets that would have gone to insurance company CEOs without the Affordable Care Act,” Grijalva said. “This law is about making health care affordable and guaranteeing that insurance companies spend their revenue on better care instead of lining a few pockets. Anyone who opposes the Affordable Care Act should explain why these rebates are a bad idea. For the rest of us, this is welcome relief.”

Any insurance company that spends more than 20 percent of each premium dollar on non-medical expenses, such as executive compensation, must provide its policyholders a rebate for the difference no later than August 1. The 80/20 rule, also known as the Medical Loss Ratio standard, requires that each insurance company inform customers of whether the company met the standard and, if not, how much will be returned to them.

Consumers owed a rebate will receive one of the following:

·         a rebate check in the mail;

·         a lump-sum reimbursement to the same account that they used to pay the premium if by credit card or debit card;

·         a reduction in their future premiums; or

·         their employer providing one of the above, or applying the rebate in a manner that benefits its employees.

For a comprehensive explanation of the 80/20 rule and a breakdown of each state’s rebates, visit

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