Left In Lowell

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June 30, 2012

SCOTUS/ACA Pay Back

by at 2:13 pm.

#middleclasswin

FallonRebateCheck


As you read the letter, below, please note that the ACA law requires a 80/20 ratio. The rebate I received is based on the requirement here in Massachusetts, which is 88/12. This is noteworthy, as detractors will attempt to assert that the ACA limits what the various states can do. Apparently, if a state wants to do better that the standard codified, the state is free to do so.

FallonRebateLetter1

FallonRebateLetter2

4 Responses to “SCOTUS/ACA Pay Back”

  1. Shawn Says:

    Funny that.. the “only health plan in Massachusetts to have been awarded “Excellent” Accreditatino by the National Committee for Quality Assurance” now has to alter is health care offering, and the staff and administration that made it so will probably be diminished.

    I’ld be interested to see how the plan offerings change over the next few years.

    Where I work, about $6000.00 of health plan costs per year have been transferred to the employees from the employer.

    Just wondering what comes next.

  2. Jack Says:

    Shawn,
    As a blogger, you should know the etiquette of adding hyperlinks to your points.

    Is this what you meant?

    Fallon Community Health Plan ranked #1 Medicaid health plan in America

    Worcester, Mass., September 20, 2011 ―Fallon Community Health Plan is the #1 Medicaid health plan in the country according to the National Committee for Quality Assurance’s Medicaid Health Insurance Plan Rankings, 2011-2012. This is the fourth time in the past five years that FCHP has achieved this distinction.

    FCHP also continued to achieve high rankings in the other two product categories included in the annual rankings. According to NCQA’s Medicare Health Insurance Plan Rankings, 2011-2012, FCHP’s Medicare HMO is ranked #12 in the country. FCHP’s commercial HMO is ranked #13 in NCQA’s Private Health Insurance Plan Rankings, 2011-2012.
    -snip

    Medicaid is the gov’t dole stuff, right? Is that Constitutional, Shawn?

    Fallon had another PR:

    Regardless of Supreme Court decision, benefits and coverage for FCHP members will not change

    Worcester, Mass., June 21, 2012―Fallon Community Health Plan, a nationally-recognized, not-for-profit health care services organization, today announced that it will continue offering products in the commercial market that include key provisions of federal health care reform legislation, regardless of the Supreme Court’s decision on the constitutionality of the Affordable Care Act.
    -snip

    Fallon isn’t pessimistic about the future.

    If you are getting stiffed by your employer, Shawn, you are free to work elsewhere.

  3. Joe S. Says:

    These rebates are now coming nationwide, even with only a 80% requirement (85% for larger insurers who are better able to spread the administrative costs).

    “Health and Human Services says it expects the average rebate for a family that buys its own insurance to be $151. The states with the highest average rebates per family in the individual market are: Mississippi ($651), Alabama ($582), Maryland ($496), Delaware ($461) and West Virginia ($383).”

  4. joe from Lowell Says:

    and the staff and administration that made it so will probably be diminished.

    Um, Shawn? You do know that this is Fallon Community Health Plan, based in Massachusetts, right?

    And that Massachusetts health care plans have been operating under “Obamneycare” for several years now, right? Including the year for which it won that “#1 Medicaid Plan in America” award.

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