Now available: 2021 Medical Loss Ratio Early Warning Payout Report and key dates

The Medical Loss Ratio (MLR) Early Warning Report key dates are now available. MLR 2021 payouts are for the 2020 MLR rebate reporting year using the 2019 average total number of employees (ATNE). 

MLR applies to fully insured plans only. Insurers must meet or exceed an MLR of 80% for the individual and small-group markets, and 85% for the large-group market.

  • MLR is based on legal entity, state and size of employer, and payouts are based on an aggregate of those factors – not on performance of a specific employer group or individual.
  • For 2021 reporting, most states use 1–50 ATNE to determine small group. Only 4 states use 1– 100 ATNE for reporting – California, Colorado, New York and Vermont.

Important dates
April 1 –
Supplemental Health Care Exhibits Report
June 18 – Early Warning Report
July 31 – Health and Human Services (HHS) MLR Rebate Reports 
Sept. 17 – MLR Final Rebate Reports 
Sept. 20 to 30 – All checks mailed 

Rebate impact
A 2021 payout forecasted for 56 aggregation sets (24 small group; 32 large group) in 31 states plus Washington, D.C. There are 4 states and 4 aggregation sets for individual policies.

When the final report is released, there may be additions or deletions to these projected states/aggregation sets.

The MLR hotline will be available beginning on Sept. 1, 2021. The line is not available prior to that date.

  • MLR Employer/Broker Hotline: 1-866-802-8602
  • Oxford MLR Employer/Broker Hotline: 1-888-201-4216 

Calculations are not based on the performance of the group. MLR uses the state, group size and legal entity to determine the calculations. Final reports and check amounts will be available on the broker portal by the end of the second week in September, prior to checks going out.

To know if your groups may receive a rebate or for questions, contact your broker or UnitedHealthcare representative.