MEDICAL LOSS RATIO (MLR) REBATES
The Affordable Care Act (ACA) requires health insurers and HMOs to spend the majority of the premium they collect on actual health benefits (excluding administration or overhead).
Plans that fail to meet the minimum MLR standard must refund a portion of premiums to their policyholders. Employers that receive a rebate from their group medical insurer or HMO need to follow certain guidelines in using the funds.
The ACA created the Patient-Centered Outcomes Research Institute (PCORI) to study clinical effectiveness and health outcomes. To finance the Institute’s work, a small annual fee is charged on group health plans.
In this webinar, Sara will cover:
• MLR rebates
• Ways an employer can distribute MLR rebates
• PCORI fees
• How PCORI fees are calculated
• Who pays the fee and how to pay the fee
You may also qualify to earn 1 HR recertification credit for your participation.*