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New York orders 11 health insurance companies to refund $114.5 million
By Insure.com staff

New York state officials ordered 11 health insurance companies to refund $114.5 million to policyholders who were overcharged for premiums in 2010.

The policies in question covered 573,748 people.

Under New York state law, health insurance companies must spend 82 cents of every dollar collected in premiums on providing medical care. If they don't meet this requirement, known as the medical loss ratio, they must refund the difference to policyholders. The amount over the 82 percent threshold goes to insurer overhead, administrative expenses and profit.

Refunds have already been made to health insurance policyholders in the small group and individual, direct-pay market. The state's Department of Financial Services instructed insurers to make refunds to policyholders in the large group market--groups with 51 or more policyholders--by Dec. 15.

"In this economic climate, every penny counts and in this case, insurance companies were overcharging New Yorkers to the tune of millions of dollars," Gov. Andrew Cuomo said in a press statement. "This should serve as a message to companies that we are watching, and we will not tolerate any action that wrongly hurts the finances of the people of New York."

The insurance companies and the refunds they are required to make are:

  • Aetna Health Inc., $11.5 million
  • CDPHP Health Plan, $487,768
  • ConnectiCare of NY, $15,462
  • Empire, $61.1 million
  • Excellus, $21.4 million
  • GHI, $4.2 million
  • Health Net of New York, $5.1 million
  • HealthNow, $4.5 million
  • HIP Health Plan of Greater New York, $182,194
  • MVP Health Plan, $1.3 million
  • Oxford Health Insurance Co. $4.8 million



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