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Some Lancaster County residents who bought their own health insurance for 2019 will soon be getting big rebates in the mail.

The Affordable Care Act requires insurers to issue rebates or credits if they spent more than 20% of individual market premiums on administration, marketing and profit over the previous three years.

Capital BlueCross said across its 21-county region nearly 40,000 members will receive checks averaging $800 per member — with some as high as $3,000. About 6,200 of those members are in Lancaster County, according to the insurer.

Normally the checks would have been sent in September, president and CEO Todd Shamash said, but it's sending them earlier because "The pandemic has caused so much uncertainty and economic hardship, we want to get this money in the hands of our members as soon as possible."

The other three insurers that sold individual plans on healthcare.gov here for 2019 — UPMC Health Plan, Geisinger Health Plan and Highmark — haven't said yet whether they will be issuing rebates this year.

Last year, Highmark reported sending checks averaging roughly $1,000 to about 5,000 Lancaster County households. Statewide, Capital BlueCross said it sent more than 29,000 checks averaging $635 last year; it attributed the increase in number of checks to having more individual members in 2019 than in 2018.

Nationwide, the nonprofit Kaiser Family Foundation estimated individual market rebates will total $1.97 billion this year, averaging $420 apiece to 4,735,000 members.

By comparison, it estimated record high rebates last year totaled $743.3 million, averaging $270 apiece to 2,748,000 members.

Rebates this year are based on financial results from 2017 through 2019, and Kaiser's analysis said the individual market began to stabilize in 2017, was "highly profitable and arguably overpriced" in 2018 and continued to perform strongly in 2019 "despite the absence of the individual mandate penalty and premiums dropping a bit on average."


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