Have you heard the rumor about the $1.1 billion in rebates coming back to healthcare insurance customers just like you because of apparent over-billing of premiums last year?

The sad reality, according to our Connecticut Healthcare Advocate Ted Doolittle, is that a little-known provision in the Affordable Care Act that is supposed to reward overcharged health insurance customers with a rebate will only be targeting the pockets of about 6.2 of the 170 million of us with either job-based or ACA (marketplace / AccessHealthCT) policies.

Our advocate in Hartford explained that under the Affordable Care Act, an admirable requirement is that healthcare insurance companies had to spend either 80 or 85 percent of their premiums covering our medical expenses vs related expenditures such as executive pay, bonuses and marketing.

As a result, insurance companies that didn’t meet that threshold, called the medical loss ratio (MLR), have to pay a rebate.

Since 2012, an estimated $11 billion has been paid out in rebates; however, while consumers in other states have received significant rebates some years, that has never happened in Connecticut. And Doolittle lamented that because of this history, it seems likely that Connecticut consumers won’t get significant rebates again this year.

Even if you may be in line for a fractional chunk from the “healthcare rebate sweepstakes,” Doolittle says if you work for an employer who is owed a rebate, the company can use the money to offset the employee cost of healthcare, leaving nothing for the end consumer.

Or, at the very least, an employer has the option to split the money proportionately.

And if you work any place that uses a self-insured plan, like the Town of Newtown and countless other commercial, municipal, and nonprofit entities, you are exempt from the rebate altogether.

A report on the issue from the Kaiser Family Foundation found some Connecticut ratepayers did receive a rebate in 2022, but when you zoom out to see the big picture, the average amount nationally was $16. It was actually South Dakota rebate recipients who received the biggest checks, on average $603.

So, like George in the memorable Seinfeld episode, even though you may be in line and doing everything right — even when there’s a pot containing $1.1 billion to go around — as far as the average Newtowner is concerned, there will likely be “No soup for you!”