UnitedHealthcare will begin mailing MLR premium rebate checks to impacted groups in September
Select customers in AR, AZ, CA, CO, DC, DE, FL, HI, IA, ID, IL, IN, KY, MA, MD, MI, MS, NE, NJ, NY, OH, OK, TN, TX, VA, WI, WV (individual only) and WY will receive an MLR rebate check.
- Regulatory and compliance
- Select states
- All Business Sizes
Premium rebate checks begin to go out mid-September and will be staggered over a three-week period. Fully insured customers who are qualified to receive premium rebates for the 2022 MLR Payout Year are expected to receive their checks by the September 30 deadline.
Primarily, rebates will be paid to the applicable policyholder. 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 mailing to policyholders, notices of the rebate also will be mailed to the subscribers of those group policyholders receiving a rebate.
For benefit plan year 2021 (2022 MLR Payout Year), UnitedHealthcare results show 40 group aggregation sets in 26 states plus Washington, D.C. — 20 small group and 20 large group — are qualified to receive premium rebates totaling $71,526,980. Also, 6 individual aggregation sets are qualified to receive rebates totaling $5,315,079.
For a summary of states, legal entities and business sizes (aggregation set) that will receive a rebate, refer to the Final MLR Rebate Report.
Broker reports for their customers will be posted on United eServices by September 16, prior to checks being mailed.
Final customer-specific results were verified in late July 2022. Prior to mailing checks, UnitedHealthcare sales and account managers, as well as brokers, will have access to rebate reports to assist customers with any questions regarding their eligibility for a rebate in September.
The reports include the amount of rebate owed and paid, as well as the MLR percentage achieved by the aggregation set in which the policyholder was grouped.
Aggregate sets and premium rebates over the past three years
2021 (2022 payout)
2020 (2021 payout)
|2019 (2020 payout)|
40 (20 small group and 20 large group)
|Premium Rebates||$76,842,058||$ 145,422,798||$ 181,858,413|
MLR Broker/Employer Service Line
Brokers and customers can call the Broker/Employer service line at 1-866-802-8602 if they have questions related to the rebate payout. The Oxford specific Broker/Employer service line is 1-888-201-4216. Both services lines opened for calls on September 1.
- MLR applies to fully insured group commercial plans and individual plans
- The law requires insurers to spend a minimum percentage of premium dollars — 80% for individual and small groups (1–50 or 1–100 depending on the market) and 85% for large group (51+ or 101+ depending on the market) — on medical services and activities designed to improve health care quality
- For the 2021 rebate reporting year, California, Colorado, New York and Vermont define small group as 1–100 and large group as 101+
- MLR is based on legal entity, situs state and MLR group size of employer — called an aggregation set
- MLR payouts are based on performance of the aggregate set, not on the performance of a specific employer group or individual
- For more information, refer to the list of states by employer size and legal entity or your specific customer reports on United eServices®
- Different rules for different plan types (e.g., ERISA, Federal Government, Non-Federal Government, Non-ERISA & Non-Government and terminated groups) are set forth in the rebate notice. Employers may contact the Department of Labor (DOL) Employee Benefits Security Administration (EBSA) at 1-866-444-EBSA (3272) or review the technical guidance on this issue on the DOL website
- Information on any tax implications on receipt of rebate payments either by the group policyholder or subscriber can be found on the IRS website
For more information, please contact your broker or UnitedHealthcare representative.
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