Health insurance premium rebates for 2017 Small Group policyholders and 2018 Consumer policyholders
As a result of a United States Supreme Court decision last year, Independence received additional payment from the Federal Government that impacted our Medical Loss Ratio (MLR) for 2017 and 2018.
Beginning the week of May 17, Small Group policyholders from 2017 and Consumer policyholders from 2018 will receive checks that are a rebate for a portion of their health insurance premiums for that year.
What is MLR?
The Affordable Care Act requires that all health insurers spend a percentage of each premium dollar received towards paying claims, clinical services, and activities that improve health care quality for members. This percentage is known as the minimum Medical Loss Ratio.
If a health insurer does not meet this MLR requirement, the insurer is required by law to issue rebates to employer groups and/or plan subscribers. Independence did not meet the standard after recalculating the MLR to account for the additional payment from the Federal Government.
Please note that the refund for groups is being distributed at the plan level, so groups may receive more than one refund check if they offered more than one plan for 2017.
How are we notifying groups and subscribers?
Letters to groups and subscribers receiving rebates are included with the checks. In addition, we are required to notify subscribers of group plans if their group is receiving a rebate.
If you have any questions, please contact your Independence account representative or your broker at Total Benefit Solutions, Inc (215)355-2121.
Impacted parties can also visit cms.gov for more information about MLR requirements.