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Rebate checks are starting to be delivered to both group and Individuals. The rebate check is a direct results of the Affordable Car Act.
Medical Loss Ratio Information‐‐The Affordable Care Act requires health insurers in the individual and small group markets to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality (in the large group market, this amount is 85 percent). This is referred to as the Medical Loss Ratio (MLR) rule or the 80/20 rule. If a health insurer does not spend at least 80 percent of the premiums it receives on health care services and activities to improve health care quality, the insurer must rebate the difference.
A health insurer’s Medical Loss Ratio is determined separately for individual, small group and large group markets in which the health insurer offers health insurance. No later than August 1, 2012, health insurers must send any rebates due for 2011 and information to employers and individuals regarding any rebates due for 2011.
