Please note: Not all states or aggregation sets will receive an MLR refund.
Medical Loss Ratio (MLR) applies to fully insured plans only. MLR 2017 payouts are for the 2016 MLR rebate reporting year using the 2015 average total number of employees (ATNE). MLR is based on legal entity, state and size of employer, and payouts are based on an aggregate —not on the performance of a specific employer group or individual.
For 2017 reporting, most states use 1 to 50 ATNE to determine small group. Those states that use 1 to 100 ATNE for 2017 reporting are Alaska, Ark., Calif., Colo., Fla., Ga., La., Neb., N.Y., Ohio, Tenn., Texas, Utah, Vt. and Wis.
April 1, 2017 – Supplemental Health Care Exhibits Report, shows preliminary MLR
Mid-June 2017– Early Warning Report
July 21, 201 – Health and Human Services MLR Rebate Reports filed
Sept. 30, 2017 – MLR Rebate Reports all mailed
Week of September 8 – Final rebate reports to UnitedHealthcare offices
Week of September 15 – Final rebate reports to brokers on their specific customers
Final two weeks in September – Rebate payments to customers
For 2017, it is anticipated that rebates will be available for some aggregation sets in 19 states, plus Washington, D.C., with a total of 38 aggregation sets forecasted for group rebates. This information will be published in the HHS MLR Rebate Report in July.
17 small group
21 large group
The MLR hotline will be available for brokers and customers in September, prior to distribution of the checks.
For more information, please contact your UnitedHealthcare representative.