September 25, 2012 Articles

MLR in Group Markets: Will Many Plan Participants Receive Rebates?

Recent data show $700 million will be going to only a small percentage of participants.

By Wayne Jacobsen, Melissa Hulke, and Sonya Kwon – September 25, 2012

Headlines have indicated that approximately $700 million in medical-loss-ratio (MLR) rebates will be distributed to consumers in the small and large group insurance markets, but the Department of Health and Human Services (HHS) continues to update MLR data, and a closer look at the recently updated data further confirms that only a small percentage of plan participants will receive rebates.

The burden of rebate distribution to plan participants in the small and large group markets generally lies with employers. As a result, employers have numerous determinations to make, including whether they may be able to retain a portion of the rebate, the group of participants to whom rebates will be distributed, the method of distribution, and how to calculate the rebate. It is important for employers to manage plan-participant expectations during the rebate-distribution process.

Premium Content For:
  • Litigation Section
Join - Now