July 10, 2020

MLR Reporting and Rebates Deadline Extended due to COVID-19

The Centers for Medicare and Medicaid Services (CMS) have extended the deadline for insurers to report Medical Loss Ratio (MLR) annual reports and rebates from July 31 to August 17, 2020. The MLR reflects the portion of insurance premium revenue spent by the insurer for enrollee health services related to the total premium revenue. If this ratio is less than 80% in the small group (85% in the large group) market, then monies (i.e., reimbursements) must be returned for distribution to enrollees. To learn more details about MLR rebates, click here: ACA Medical Loss Ration Rebates. *Note: with less usage of the health system due to COVID-19 this year, more insurer rebates may be paid to employers who then (under a fiduciary duty as plan sponsor) must distribute in accordance with ERISA group health plan requirements.

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