Thursday, June 27, 2013

MLR: More Loony Results

And the hits just keep on comin'. Last week, LifeHealthPro's Allison Bell reported that "insurers did a better job of meeting the new federal minimum medical loss ratio (MLR) targets in 2012 than in 2011, and they will end up paying fewer rebates to a smaller number of people."

Maybe so, maybe not:

■ FoIB Jeff M tips us that "North Carolina health insurance consumers will receive close to $10 million in [MLR] rebates"

But how will the other 57 states fare?


Via email, we learn that "[b]eginning in June and by August 1st, Aetna is scheduled to mail rebate notices and checks to policyholders and subscribers whose plans are due a rebate ... In this second year of MLR reporting, Aetna's rebates represent 0.2 percent of the premiums we collected"

That's down quite a bit from last year (the first for which MLR "rebates" were due), which the carrier interprets as indicating that they've met their pricing goal.


United Healthcare is also rolling out their 2013 MLR rebate initiative. Via email we learn that:

"In the second Medical Loss Ratio (MLR) Reporting Year, UnitedHealthcare’s results show that 83 Aggregation Sets in total (group and individual combined) qualified to receive premium rebates totaling $149,861,252 for 2012."

That's also down from last year; in fact this year's rebates are less than half of last year's.


  Interestingly, both carriers indicate that the checks will be going to the group (employer) for distribution. Chalk that up as one more accounting and tax headache for businesses.

Guess who pays for that?
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