Four insurance companies, including two in Westchester County, owe New York seniors more than $2 million for underspending on medical claims with their premium payments.
The insurers are American Progressive Life and Health Insurance Co. of New York in White Plains, Transamerica Financial Life Insurance Co. in Harrison, Excellus Health Plan Inc. in Rochester and First United American Life Insurance Co. in Liverpool.
The  four insurers will pay $2.2 million in restitution to 3,475 New Yorkers statewide, according to the state Department of Financial Services. The refunds are for Medicare supplemental insurance products and average $624 per policyholder. Fund distribution will begin Sept. 30.
American Progressive will distribute the largest share of refunds, $968,075, to about 650 policyholders. Transamerica will refund $852,418 among some 2,280 policyholders.
Benjamin Lawsky, superintendent of Financial Services, ordered the refunds after the department found the insurance companies did not meet the state’s medical loss ratio requirement,  which requires insurers to spend a percentage of premium revenue on patients’ medical claims. For-profit Medicare insurers must spend at least 65 percent of premium dollars on medical claims for individual policies and 75 percent for group policies. Nonprofit insurers must allocate at least 80 percent of premiums to medical costs for all policies.
“We will continue to vigorously enforce these critical consumer protections, which help keep premiums down and insurance companies honest,” said Lawsky in a written statement. “That’s especially important for New York’s seniors, many of whom live on fixed incomes.”
