MCMURRAY, Pa.--(BUSINESS WIRE)--In the latest Healthcare Business Strategy report, Mark Farrah Associates, www.markfarrah.com, summarized key findings from the 2017 MLR report released in December of 2017 by the Department of Health and Human Services (HHS). The Affordable Care Act’s (ACA) MLR provision requires health insurers who fail to spend specified percentages of their health care premium income to pay rebates to their customers. The goal of this provision is to curb growth in health care premiums while ensuring that plans are adequately covering healthcare expenses. This brief focused on health plan performance as it relates to the Medical Loss Ratio, and the related rebates subsequently due to consumers.
- For 2017, lower MLRs resulting from increased profitability overall, led to $709 million in reimbursements to customers, equating to approximately $119 per benefiting family.
- For 2017, California led the country with over $97 million in total MLR rebates paid to customers, a significant increase from $17 million in 2016.
- 2017 MLR rebates paid for the Individual segment were $132 million which is .17% of the $77 billion collected in premiums.
- MLR Rebates for the Small Group segment were $311 million, or .44% of the $71.2 billion in premiums collected in this segment.
- Rebates for the $220.2 billion Large Group segment were $266 million.
Subscribers to Mark Farrah Associates' Health Coverage Portal and the SHCE and MLR Data have access to this dataset with the benefit of NAIC company codes mapped to HIOS codes used for government reporting by health plans. To read the full text of "The 2017 Health Insurance Medical Loss Ratio and Rebates Results: A Brief Summary", visit the MFA Briefs on Mark Farrah Associates' website.
About Mark Farrah Associates (MFA)
MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include Medicare Business Online™, Medicare Benefits Analyzer™, Health Coverage Portal™, County Health Coverage™, and Health Plans USA™. Mark Farrah Associates maintains financial data as well as enrollment and market share for the health insurance industry in its subscription-based Health Coverage Portal™. MFA will continue to monitor enrollment changes and competitive shifts across all healthcare segments.