The 2019 Medical Loss Ratio (MLR) payout key dates are now available. MLR 2019 payouts are for the 2018 MLR rebate reporting year using the 2017 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 performance of a specific employer group or individual.
- Most states use 1 to 50 ATNE to determine small group. Only 4 states use 1 to 100 for 2018 reporting – California, Colorado, New York and Vermont.
Important dates for 2019 MLR payout
April 1 – Supplemental Health Care Exhibits Report
- Filed; shows preliminary MLR
June 7 – Early Warning Report
- Brokers may contact UnitedHealthcare to see if their groups may be eligible for a rebate
July 31 – Health and Human Services (HHS) MLR Rebate Reports
- Filed and publicly available on healthcare.gov
Sept. 10 – MLR Rebate Reports
- First week of September – Final rebate reports to UnitedHealthcare markets receiving rebates
- Second week of September – Final rebate reports to fully insured brokers on their specific customers
Sept. 15 to 30 – All checks mailed and MLR hotline will be open prior to mailing
- Third and fourth weeks in September – Rebate payments mailed to eligible fully insured customers
MLR calculations for groups are not based on the performance of the group. MLR uses the state, the group size and legal entity to determine the calculations. A 2019 payout forecasted for 48 aggregation sets (22 small group; 26 large group) in 28 states, plus Washington, D.C. Brokers will have the preliminary information in June and the final report and payout amounts for customers in early before checks are mailed out in September.