BOSTON — Imagine opening your mailbox this fall and finding a check from your health insurance company. That’s the reality for more than 350,000 Massachusetts residents and small-business employees who will soon share in $75.6 million in health insurance rebates.

The Healey-Driscoll administration confirmed this week that five major insurers will be issuing refunds, marking an increase of about $24 million compared to last year’s $51.6 million total (Mass.gov, WBUR).

Why Are Insurers Sending Money Back?

This isn’t just corporate goodwill—it’s the law. Massachusetts requires health insurers covering individuals and small groups to spend at least 88% of premium dollars on actual medical care and quality improvements. That’s stricter than the federal Affordable Care Act’s 85% requirement.

When insurers fall short of that standard over a three-year period, they must return the difference to policyholders. These refunds come either as direct checks or credits on future premium payments, depending on your carrier.

Michael Caljouw, the state’s Division of Insurance Commissioner, said the refunds highlight Massachusetts’ commitment to protecting consumers. “These rebates are dollars back in the pockets of families and small businesses—while keeping insurers accountable to efficiency and affordability,” Caljouw explained.

Who’s Paying Out the Rebates?

Five insurers didn’t meet the 88% spending threshold and will now be issuing refunds:

1. Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.

2. Fallon Community Health Plan, Inc.

3. Harvard Pilgrim Health Care, Inc.

4. Mass General Brigham Health Plan, Inc.

5. UnitedHealthcare Insurance Company

Refunds are scheduled to begin in September 2025. If you’re covered by one of these companies in the individual or small-employer market, expect either a rebate check in your mailbox or a credit applied to your next bill.

The size of your rebate depends on your insurer and how much you or your employer paid in premiums over the qualifying period.

Why This Matters for Policyholders

For many families, small-business owners, and self-employed workers, health insurance premiums can feel like a monthly burden. While a rebate isn’t life-changing, it’s a welcome relief—and a reminder that regulators are watching out for fairness in the marketplace.

This also signals something bigger: Massachusetts continues to lead the nation in consumer-friendly health insurance policies, going beyond federal standards to ensure that premiums truly benefit patients, not just administration.

Are These Five Carriers Still Good Choices?

Yes. While rebates mean insurers spent less than required on care, it doesn’t necessarily mean poor performance. In fact, these companies remain some of the top-rated health insurance providers in Massachusetts:

• Blue Cross Blue Shield of Massachusetts – The state’s largest nonprofit health insurer, known for strong customer service, extensive provider networks, and commitment to innovation (BCBSMA Newsroom).

• Fallon Community Health Plan – Community-driven and praised for affordable plan options.

• Harvard Pilgrim Health Care – Consistently ranked high in quality of care and preventive services.

• Mass General Brigham Health Plan – Backed by one of the state’s top hospital networks, offering integrated care.

• UnitedHealthcare – A nationwide powerhouse with broad access to providers and flexible plan designs.

Each of these insurers has strong reputations and wide networks, making them solid choices even as they issue refunds.