Managing Anthem Small Group Medical Loss Ratio Rebates

Who doesn’t love a good rebate? Granted, usually you have to jump through some hoops including filling out forms, providing documentation, receipts and even sending in coupons or special activation codes. But still, it’s great getting that rebate check back, right?

Well, as you may know, the Affordable Care Act (ACA) established medical loss ratio (MLR) rules to help control health care coverage costs and ensure that enrollees receive value for their premium dollars. The MLR rules require health insurance issuers to spend 80-85 percent of premium dollars on medical care and health care quality improvement, rather than administrative costs.

And issuers that do not meet these requirements must provide rebates to consumers/employees. Rebates must be provided by September 30 following the end of the MLR reporting year. For the 2017 reporting year, issuers are required to pay rebates by Sept. 30, 2018. The only carrier in California that we know of who is issuing rebates this year is Anthem Blue Cross.  

So Anthem Blue Cross rebates just may be coming your way. And you will have the option to distribute checks to your employees or apply the funds toward future premiums. Employee letters are also required to be mailed and will be sent by the carriers this month. My team of health insurance and employee benefits experts is standing by to help you better understand and rule your rebates this year. Just contact us with any questions or issues.  

Learn Moore:

68557 HCR How Employers Should Handle MLR Rebates

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