Medical Loss Ratio Rebates: What the Requirements Mean for Employers Who Sponsor Group Health Plans and Their Employees

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New requirements in the Patient Protection and Affordable Care Act (PPACA) affect employers who sponsor group health plans and their employees. Here’s what to expect, and how to prepare.

Employers that sponsor group health insurance plans are beginning to receive notices regarding the medical loss ratio (MLR) requirements created by the Patient Protection and Affordable Care Act (PPACA). For some plan sponsors, the law will result in a rebate from the insurance company for a portion of premiums paid in 2011. How a plan sponsor responds to the notice depends on a number factors, including the type of employer, the cost-sharing arrangements of the plan, and whether the plan is subject to the Employee Retirement Income Security Act (ERISA).

This document has been developed to help the employer that sponsors a group health plans to understand MLR rebates and the requirements for distribution of the rebates.

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