California Medical Insurance: Accountability for Companies Equals Savings for Consumers

May 17, 2010

Under the new health care reform act insurance companies are now going to offer rebates for consumers who pay too much. The new rules will call for insurance companies to report the amount of annual income earned from California medical insurance premiums. They will also report the amount they spend on medical services, profits, advertising, or marketing. The law states that California medical insurance companies will have to spend at least 75% of the money taken in on medical services, not overhead costs. If the company spends less than 75% on medical fees, consumers will be entitled to a rebate annually.

Public Sharing of Information

Each insurance company will report the amount of money earned and spent online. Consumers will have the right to review these numbers at their own discretion. Insurance companies will report earnings on a regular basis.  If a company wants to raise rates across the board, for all consumers, this news will also be posted online for consumers. Rate increases must be justified in order to take effect.

Appeals Process Changes

California medical insurance companies will also change the way appeals are handled. Consumers will have the right to appeal a decision that was made about their coverage. If the individual feels that the insurance company did not pay enough or that coverage was denied without just cause, the appeals process will be available.

All of these changes will allow consumers to better understand their policy. Most insurance companies have stated that they look forward to these changes. After all, consumers are more likely to stay with a company that they trust and understand.

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