Five Massachusetts health insurers will be returning $75.6 million to more than 350,000 people in the state covered by individual and small-employer plans, the Massachusetts Division of Insurance announced in a press release.
This is $24 million more in rebates than the amount refunded to policyholders last year—which was $51.6 million, the state’s Division of Insurance said.
The announcement came shortly after the Division of Insurance announced it had negotiated down proposed rate increases from six health insurers, which it said would save policyholders in the state around $54 million in health care premiums in 2026.
Newsweek has contacted the press office of the Massachusetts Division of Insurance via email outside of regular working hours for comment.
Why It Matters
The rebates will provide direct financial relief for Massachusetts households and small employers at a time when health costs are extremely high, outpacing inflation, even though the U.S. spends more on healthcare per capita than any other nation.
Jacob Wackerhausen/Getty Images
What To Know
Massachusetts has strict regulations on Medical Loss Ratio (MLR) law, a regulatory requirement that obliges health insurance companies to allocate a substantial portion of their premiums on health care provision.
If a health insurer’s MLR falls below a certain percentage, the insurer will be required to issue rebates to policyholders—keeping insurers accountable and increasing transparency over how insurers use the revenue generated from premiums.
Massachusetts has some of the strictest MLR laws in the country, according to the state’s Division of Insurance, requiring insurers to meet an 88 percent MLR for individual and small-group plans, while the federal standard is 85 percent.
In Massachusetts, this means that when a health insurer falls below this standard for a three year period, a portion of premium payments must be returned to policyholders.
These rebates can either be paid directly as a check or credited on future premium payments.
The exact amounts of the rebates returned to policyholders depend on the carrier and the premium paid by individual and small group purchasers.
The five state health insurers issuing rebates are Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.; Fallon Community Health Plan, Inc.; Harvard Pilgrim Health Care, Inc.; Mass General Brigham Health Plan, Inc.; and UnitedHealthcare Insurance Company.
What People Are Saying
Governor of Massachusetts Maura Healey said in a statement: “Massachusetts has strong laws in place to make sure that the money that you are paying for health care actually goes to covering high-quality services. That’s why we are able to approve over $75 million back to consumers and businesses. This is just the latest action we are taking to lower the cost of health care, housing and energy that people are facing every day.”
Massachusetts Division of Insurance Commissioner Michael Caljouw said in a statement: “These rebates are more than just numbers—they’re dollars back in the pockets of families and small business owners across the Commonwealth. The enforcement of this law is part of our larger strategy of protecting Massachusetts health care consumers and encouraging insurers to be more efficient, reduce administrative overhead and focus on cost-effective ways to deliver care.”
What Happens Next
The five state carriers will start to refund policyholders in September, the state’s Division of Insurance announced.
