HEALEY-DRISCOLL ADMINISTRATION APPROVES $75.6 MILLION IN HEALTH INSURANCE REBATES FOR CONSUMERS AND SMALL BUSINESSES

The following information was released by the office of the Governor of Massachusetts:

Governor Maura Healey and Lt. Governor Kim Driscoll

Division of Insurance

Governor Maura Healey's Division of Insurance announced today that five of the state's health insurance carriers will return $75.6 million to over 350,000 people covered by individual and small employer plans in Massachusetts under the state's enforcement of the Massachusetts health laws.

Massachusetts has the country's strictest Medical Loss Ratio (MLR) law, requiring the state's health insurance carriers to spend at least 88 percent of premiums on health care services for individuals and small groupssetting a higher bar than the federal standard of 85 percent. When an insurance carrier's average MLR over a three-year period falls below the required threshold, it is required to rebate a portion of premium payments to individuals and small employers. The rebates reflect a portion of the difference between what the insurance carriers charged in premiums and what they actually spent on health care costs. The rebates may be paid directly as a check or credited on future premium payments.

"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," said Governor Healey. "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."

"These rebates are more than just numbersthey're dollars back in the pockets of families and small business owners across the Commonwealth," said Division of Insurance Commissioner Michael Caljouw. "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."

The exact amounts of the 2025 rebates depend on the carrier and the premium paid by individual and small group purchasers. The amount to be refunded this year is $24 million more than the 2024 rebate of $51.6 million.

Today's announcement comes closely on the heels of the Division of Insurance's regulatory review of filed rates for 2026 that are projected to save Massachusetts consumers more than $77 million in future premium costs. Carriers will begin refunding amounts to policyholders starting in September. The five carriers providing 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. Together, these insurers are issuing rebates to over 350,000 people covered in individual and small employer plans in Massachusetts.