Medical insurance companies playing games with the numbers

medical insurance
medical insurance

Starting in 2011, medical insurance companies will have to meet new rules on profitability. They will need to spend at least 85% of dollars collected in premiums for the large group market on medical care and at least 80% of premiums collected in the individual and small business group market on medical care.

Most are not meeting these goals, especially in the individual health insurance marketplace -- and some are starting to reclassify expenses so they don't have to pay a rebate to consumers in 2011.

Based on a study by the Oversight and Investigations staff of the Senate Committee on Commerce, Science and Transportation, at least one company, Humana, spent only 68.1% of the premiums it collected from individuals in 2009 on medical spending. The committee staff prepared the report for its chairman, Sen. John D. Rockefeller IV (D-WV). Humana has the worst record, but others that fall below the required 80% in the individual marketplace include Aetna (75.7%), Coventry (71.9%), UnitedHealth (70.5%), and WellPoint (74.9%).

Originally published