MLR Premium Rebate Checks Begin Mailing in September for Impacted Groups

UnitedHealthcare customers who are qualified to receive premium rebates for the 2019 Medical Loss Ratio (MLR) Payout Year are expected to receive their checks by the September 30, 2019 deadline. For a full summary of which states, legal entities and size of business (aggregation set) will be receiving a rebate, refer to the UHC 2019 MLR Final Payout Report.

Final customer-specific results were verified in late August 2019. Prior to mailing checks brokers will have access to rebate reports to assist customers with any questions regarding their eligibility for a rebate in September. Broker reports for their customers will be posted on UeS by September 13, 2019, prior to checks being mailed. 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.

Premium rebate checks will begin to go out by the end of the second week in September and will be staggered over a three-week period. All required payments are expected to be received 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.

MLR Broker and 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.

Background

  • MLR applies to fully insured group commercial plans and individual plans.
  • The law requires insurers to spend a minimum percentage of premium dollars (80 percent for individual and small group (1-50, or 1-100 depending on the market) markets and 85 percent for large group (51+ or 101+ depending on the market) on medical services and activities designed to improve Health care quality.
  • For 2018 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.
  • Payouts are based on an aggregate — not on the performance of a specific employer group or individual. An aggregation set is the combination of 1) situs state, 2) legal entity and 3) MLR group size. For more information, refer to the list of states by employer size and legal entity or your specific customer reports on United eServices®.