About your Highmark rebate
You recently received a notice that a rebate check is headed your way. It’s real — we promise. Cash it as soon as you can.
If you have questions about your rebate, we’re here to help.
Take a look below.
Your monthly premium is based on our estimate of potential health care costs for the year. In 2022, claims costs were lower than expected.
The Affordable Care Act requires we spend at least 80% of all premiums on health care services and wellness programs. Since we didn’t reach that number, you’re receiving a rebate. What’s left will help us cover business expenses like administrative and overhead costs. Now that’s what we’d call that a win-win.
In short, because of members like you. By working hard to stay healthy — by keeping up with things like preventive visits with your doctor and working with our Care Management Team to manage chronic conditions — claims were lower. We also did our part to work with providers to reduce costs.
No, not necessarily. When we set premium rates, it’s based on our estimate of what claims will be for all the people we cover.
Cost increases are typically the result of a rise in hospital stays, ER visits, doctor visits, prescription drugs, and how often health care services are used.
If you were the plan holder, enrolled in a plan in which members are receiving a rebate, you’ll get a package with your check that includes additional information about your rebate — so, check your mailbox.
Yes, your rebate is only for the premiums you paid in 2022.
No. Each member's rebate amount is determined based on the premiums they paid throughout the year.
Everyone’s situation is different. The best thing to do is to check with a tax advisor.
Call Member Service at the number on the back of your ID card. Member Service will check your eligibility, make sure the correct address is on file, and get things squared away. Or, call 800-544-6679.
That’s hard to answer right now. Next year could be different because rebates are based on things like:
• Medical costs for all members under your company’s Highmark plan.
• Money spent on health and wellness initiatives.
• Premiums paid.
• Taxes and other fees.
Not necessarily. We work hard to price our plans so that we can cover your health care costs. We also set aside a small amount into a reserve so that you’re always protected.
We’re working hard to decrease health care costs by letting you know about all of your care options and by giving you access to health and wellness programs.
And remember, premiums are based on a set formula that includes:
• Past claims history.
• Overall increases in health care cost trends.
• Other factors, including government requirements.
Cash your check as soon as you get it. If you don’t, we’ll follow up with reminders.
No, insurers across the country are giving rebates. If you want to know more, visit healthcare.gov.
