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MLR Rebates Require Careful Consideration

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



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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