Employers with insured group health plans may receive medical loss ratio (MLR) rebates if their health insurance issuers did not meet the required MLR percentages for 2022, with rebates due by September 30, 2023, in the form of premium credits or lump-sum payments. Click here for article.
Rebate Usage: Employers must use any rebate amount qualifying as a plan asset under ERISA for the exclusive benefit of plan participants and beneficiaries, ideally within three months to avoid trust requirements.
MLR Rules: Health insurance issuers must spend at least 85% of premiums on medical care for large group markets and 80% for small and individual group markets, reporting their spending annually to the federal government.
Rebate Distribution: Employers must distribute the plan asset portion of the rebate to participants fairly or use it for permissible plan purposes, such as future premium payments or benefit enhancements.
Compliance and Communication: Employers should be prepared to explain the rebate and its allocation to employees and ensure compliance with ERISA's requirements.
Comments