Aetna has restated the amount of money earned from premiums that it spent on patient care for small-business customers last year after two Senate committees began investigating the matter.
Aetna disclosed on Dec. 2 that it misclassified $4.9 billion in 2008 as small-group premiums, when really they should have been classified as large-group premiums. In other words, the insurer spent fewer premium dollars on medical care for small business clients than previously disclosed.
“It was a simple mistake,” said Cynthia Michener, spokeswoman for Hartford, Conn.-based Aetna.
Last August, the Senate Commerce Committee began investigating how major health plans spend premiums from individuals and small businesses. Key to this is the so-called medical-loss ratio, the percentage of premium dollars spent on claims versus other expenses such as plan administration and overhead. Michener said the error was discovered after another inquiry from the Senate Health, Education, Labor and Pensions Committee.
“This is yet another example of why we need more transparency and accountability in the health insurance industry,” Sen. Jay Rockefeller (D-W.Va.), chairman of the Commerce Committee, said in a statement.
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