FARGO – Blue Cross Blue Shield of North Dakota (BCBSND) has exceeded the minimum requirements in the health care reform legislation governing how much of members' premiums dollars are paid out in medical claims. Insurers who did not meet MLR requirements are required to send rebates to members.
A total of 98 percent of individual plan members' premium dollars went toward medical claims in 2011, leaving 2 percent to pay for administrative costs and go toward reserves. In 2011, BCBSND paid out 92.1 percent of members' premiums dollars in medical claims in its large employer group and 87.6 percent of member claims in its small employer group. As a non-profit mutual insurance company, BCBSND does not have profits, so what is left over after paying member claims and administrative costs is pooled in reserves to create a safety net for members in the event of higher than expected claims.
"At BCBSND we are committed to finding solutions for affordable health care in North Dakota. A big part of that is remaining a good steward of our members' premiums. We continue to look for ways to improve our efficiency and manage our resources," said Paul von Ebers, president and CEO of BCBSND.
The Affordable Care Act (ACA) health care reform law requires all insurance companies to pay out 85 percent or more of premiums collected in large employer groups for medical claims and 80 percent of premiums collected to go toward medical claims in both small employer groups and individual plans. The percentage of premiums going toward paying member claims and activities related to improving care quality is known as the Medical Loss Ratio (MLR). BCBSND recently mailed letters to members informing them that the company had met and exceeded the federal MLR requirements.
"Our performance illustrates that we consistently achieve some of the lowest administrative costs among insurance companies," von Ebers said.
BCBSND is a not-for-profit mutual insurance company governed by a 13-member board of directors. Its mission is to offer the best-possible health insurance coverage while providing superior value and service to members. BCBSND is leading efforts to control costs and is working together with doctors, hospitals and others to help improve North Dakota's health care system. The company is proud of its history of serving North Dakotans for more than 70 years.
BCBSND is an independent licensee of the Blue Cross and Blue Shield Association.