In the fourth Medical Loss Ratio (MLR) Reporting Year, UnitedHealthcare’s results show that 76 Aggregation Sets in total (group and individual combined) qualified to receive premium rebates totaling $117,626,280 for 2014. For the 2013 Reporting Year, 86 Aggregation Sets qualified for premium rebates totaling $89,902,103. An Aggregation Set is the combination of situs state, legal entity and group size.
A total of 53 Aggregation Sets in the Group Market qualified to receive a premium rebate, compared to 56 the previous year. In the Individual Market, 23 Aggregation Sets qualified for rebate this year compared to 30 for 2013.
Premium rebate checks will begin mailing in mid-September and will be staggered over a three-week period, with all required payments expected to be made by the September 30 deadline set by the U.S. Department of Health and Human Services (HHS). Rebates will primarily be paid to the applicable policyholder; however, in a limited number of cases where a group policyholder written assurance was required but not received, the subscribers of those groups will receive the premium rebate checks.
In addition to the checks mailed to policyholders, notices of the rebate also will be mailed to the subscribers of those group policyholders receiving a rebate. Unlike the first MLR Reporting Year, no notices will be mailed to policyholders and relevant subscribers who did not qualify for a rebate.
If you have any questions about MLR rebates, give us a call!