Is Your Health Insurance Provider Overbilling You?

State regulators in Wisconsin say Milwaukee-based Assurant Health overbilled an unspecified number of small businesses and will have to pay refunds to those clients.

It’s not yet clear how many of Assurant Health’s small employer clients, those having fewer than 50 employees, had to pay higher health insurance premiums because of the miscalculations or how far back the miscalculations stretch.

During an investigation by the Wisconsin Office of the Commissioner of Insurance found that Assurant Health, which was known as Fortis Health Insurance Co. until 2004, regulators pointed out potential overbillings in a sampling of 2002 and 2003 policies. The investigation was the result of an unusually high number of complaints filed against the insurer in 2002 and 2003.

Investigators found that Fortis erroneously used occupation as a factor in determining small group insurance rates. Wisconsin state law bars insurers from considering occupation in determining those rates, although factors including age, sex and health of the group can be considered. Excluding certain factors in setting rates helps insure more common rates and smaller rate swings for small businesses, state regulators said.

The amount that was overbilled will be better known by early June, when Assurant must report a more detailed account of the error to Wisconsin regulators, Susan Ezalarab, director of the insurance commissioner’s Bureau of Market Regulations, told the Business Journal of Milwaukee. Ezalarab declined to estimate how many customers were affected, or how large Assurant’s reimbursement to those clients might be.

Assurant has traditionally been known to higher premiums for its small group insurance products, Jon Cyganiak, an agent with Brookfeild-based Cyganiak Planning Inc. told the Business Journal of Milwaukee. Large-scale small employer miscalculations are rare, he said.

Assurant Health is one of four operating divisions of Assurant, Inc., which comprises the U.S. insurance operations that European financial conglomerate Fortis Inc. spun off as a publicly traded company in an initial public offering in February 2004.

You may like these other stories...

By Cathy Stopyra and Todd SimmensUnderpayment interest, refund interest, and penalties charged to businesses are just a few of the considerations the IRS calculates when determining taxation for a given company. Though...
FASB mulling a revamped income statementDavid M. Katz of CFO wrote on Tuesday that the Financial Accounting Standards Board (FASB) is in the early stages of researching whether to launch a project aimed at improving and...
You have a big presentation forthcoming that might enable you to land a huge client for your firm. Are you sufficiently relaxed to be at your best? Let me offer a story and some observations that drive home a crucial point....

Upcoming CPE Webinars

Jul 24
In this presentation Excel expert David Ringstrom, CPA revisits the Excel feature you should be using, but probably aren't. The Table feature offers the ability to both boost the integrity of your spreadsheets, but reduce maintenance as well.
Jul 31
In this session Excel expert David Ringstrom helps beginners get up to speed in Microsoft Excel. However, even experienced Excel users will learn some new tricks, particularly when David discusses under-utilized aspects of Excel.
Aug 5
This webcast will focus on accounting and disclosure policies for various types of consolidations and business combinations.