MLR Premium Rebate checks will be mailed to impacted groups in September
MLR payouts vary by legal entity and size of group for states getting a rebate. Payout is not based on individual group performance, and not all states get rebates. Specific customer information will be available mid-September.
- North Carolina
- New Jersey
- New Mexico
- New York
- South Carolina
- Fully Insured
- Legal and Compliance
- Plan Administration
Fully insured customers who are qualified to receive premium rebates for the 2020 MLR Payout Year are expected to receive their checks by the Sept. 30 deadline.
For benefit plan year 2019 (2020 MLR Payout Year), UnitedHealthcare’s results show 58 group aggregation sets—25 small group and 33 large group—qualified to receive premium rebates totaling $180,529,025. For a summary of which states, legal entities and size of business (aggregation set) will be receiving a rebate, refer to the Final MLR Rebate Report.
Broker reports for their customers will be posted on United eServices by Sept. 15, prior to checks being mailed.
Final customer-specific results were verified in late August 2020. Prior to mailing checks, UnitedHealthcare sales and account managers and brokers will have access to rebate reports to assist customers with any questions regarding their rebate eligibility in September.
Reports include the amount of rebate owed and paid, as well as the MLR percentage achieved by the aggregation set in which the policyholder was grouped. Below is a table that shows aggregate sets and premium rebates over the past three years:
|2019 (2020 payout)||2018 (2019 payout)||2017 (2018 payout)|
|Premium Rebates||$ 181,858,413||$169,633,214||$150,676,168|
Premium rebate checks begin to go out mid-September and will be staggered over a three-week period. All required payments are expected to be received by the Sept. 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 sending checks to policyholders, notices of the rebate also will be mailed to subscribers of those group policyholders that receive a rebate.
MLR Broker and Employer Service Line
Brokers and customers can call the Broker/Employer service line at 866-802-8602 with questions related to the rebate payout. The Oxford specific Broker/Employer service line is 1-888-201-4216.
- 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 group (1-50, or 1-100 depending on the market) markets and 85% for large group (51+ or 101+ depending on the market) on medical services and activities designed to improve health care quality.
- For 2019 rebate reporting year, the following 4 states define small group as 1 – 100 and large group as 101+: California, Colorado, New York and Vermont.
- 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®.