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Medical Loss Ratio Rebates (Sep 30)

 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 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?
SHRM

Medical Loss Ratio: Employer Guide
PPI Benefits | 2023

It's Medical Loss Ratio Rebate Check Time Again
Word & Brown | Aug 2023

2023 Medical Loss Ratio Rebates
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Preparing for Medical Loss Ratio (MLR) Rebates
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MLR Rebates: How Employers Should Handle Them
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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

FAQs
IRS

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