Medical loss ratio (MLR) rebates are mandated under the Affordable Care Act whenever health insurers do not spend at least a certain percentage (generally, 80% to 85%) of the prior year's health insurance premiums on health care services. If they fail to meet these standards, the insurance companies are required to provide a rebate to their customers. Rebates are due to policyholders by September 30 each year. Within 3 months of receipt from the insurer, employers must disburse the rebate.
For employer-specific information, check with your employer's health insurance carrier.
Disbursing the Rebate
How should employers disburse medical loss ratio (MLR) rebates from insurance carriers?
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Federal Government Resources
Guidance on Rebates for Group Health Plans Paid Pursuant to the Medical Loss Ratio Requirements of the Public Health Service Act
DOL Technical Release No. 2011-04
Medical Loss Ratio
Notice to Group Policyholders and Their Subscribers, Rebate Sent to the Policyholder (Notice #2)
Notice to Subscribers of Group Policyholders, Rebate Sent to the Subscribers (Notice #3)
CMS
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