Medical insurance companies playing games with the numbers

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%).