Missouri’s biggest individual insurer must rebate almost $90 million to policyholders because it spent too little on care and too much on administration.

Ambetter from Home State Health, a subsidiary of Clayton-based Centene Corporation , is mailing checks totaling $87.5 million to customers in Missouri because it violated the Medical Loss Ratio requirements of the Affordable Care Act. Letters dated Sept. 10 notifying policyholders of the rebates — equal to more than one month’s premium for each — began arriving in mailboxes over the weekend.

One of Ambetter’s competitors, United Healthcare, is also making rebates to Missouri customers. In a Sept. 5 news release, United Healthcare stated that it will rebate $192.2 million nationally for group market plans offered in 31 states and $

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