BCBSNC Exceeds Affordable Care Act’s 2012 Medical Loss Ratio

  • Company spends additional $260 million on customers’ health care

CHAPEL HILL, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) announced today that the company exceeded the federal requirement for health care spending by $260 million, while insurers who failed to meet the requirement must issue rebates to their customers.

The 2012 MLR rule for North Carolina required that spending on health care services and improving health care quality be at least 80 percent of premium revenues for individuals, 80 percent for small groups and 85 percent for large groups.  Insurers who fail to meet those requirements must issue the difference in the form of rebates.  Unlike some insurers, BCBSNC MLRs exceeded these requirements at 88.7 percent for individual, 85.2 percent for small groups and 91.5 percent for large groups.

“The fact that Blue Cross and Blue Shield of North Carolina exceeded the federal requirement for health care spending in 2012 means that we spend at least an extra $260 million on our customer’s health care in contrast to our competitors who are issuing rebates,” said Brad Wilson, CEO and president of BCBSNC.

During 2012, BCBSNC spent 87 cents per premium dollar on the medical care of its customers. That is up 2 percentage points from the previous year’s MLR at 85 per cent. BCBSNC had a net income ratio (profit margin) of 1 percent for 2012, equating to 1 cent for each dollar of revenue. 

 

About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.74 million members, including approximately 1 million served on behalf of other Blue Plans. For generations, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina was recognized as one of the World’s Most Ethical Companies by Ethisphere Institute in 2012 and 2013. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit BCBSNC online at bcbsnc.com. All other marks are the property of their respective owners.

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