The Medical Loss Ratio (MLR) rebate report from UnitedHealthcare (UHC) for the 2017 benefit plan year is set for release this month. Results show more than $150 million in MLR premium rebates across 49 aggregation sets (43 for Group business and six for Individual business). That rebate number mirrors the 2016 plan year, although total MLR rebates are up one-third as compared to the payout last year for 2016.
Customer-specific results were verified by UHC in August. Check distribution is expected to begin in mid-September. Final rebate reporting at the case level will also occur in September.
Rebates are payable to the applicable policyholder. In limited cases, where a policyholder’s written assurance was required and not received, the subscribers in those groups will be issued rebate checks. Notices of the rebate are also mailed to subscribers in groups receiving a rebate.
The MLR rebate requirement of the Affordable Care Act mandates insurers spend a minimum percentage of premium dollars (80 percent for Individual and Small Group markets and 85 percent for Large Groups) on medical services and activities to improve health care quality. In California, Small Group is defined as those organizations with 1-100 employees, while Large Group is defined as those firms with 101 or more employees. Payouts are based on an aggregate, not on the performance of a specific individual or employer group.
Brokers or customers with questions concerning MLR rebates should contact the UHC service line at (866) 802-8602.