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MLR Rebates Require Careful Consideration

Oct 9, 2015 8:46:44 AM / by Deborah Hyde posted in 2015 ACA, ACA, Affordable Care Act, Deborah Hyde, ERISA, medical loss ratio, MLR, MLR Rebates, Front Page Post

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Under the Affordable Care Act, insurance carriers are required to spend a minimum percentage of premium dollars on medical care and health care quality improvement. This minimum percentage is referred to as “medical loss ratio” (MLR) and is set at 85% for large group market issuers, 80% for issuers in the small group and individual markets. Any issuer that does not meet the MLR standard for a year must provide a rebate to its policyholders. MLR rebates for 2014 were due to policyholders by September 30, 2015.

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