Missouri’s biggest individual insurer must rebate more money to policyholders in the state than all insurers nationwide have in either of the past two years 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 more than $1 billion 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 reba

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