MCMURRAY, Pa.--(BUSINESS WIRE)--In the latest Healthcare Business Strategy report, Mark Farrah Associates, www.markfarrah.com, summarized key findings from the 2019 MLR report released 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 2019, due to three years of profitability and lower MLRs overall, health plans paid $2.5 billion in rebates to over 11 million customers.
- For 2019, Texas led the country with almost 280 million in MLR rebates, a significant increase from nearly $93 million in 2018.
- 2019 MLR rebates paid for the Individual segment were $1.7 billion which is 2% of the $85.5 billion collected in premiums.
- MLR Rebates for the Small Group segment were $423 million, or 0.58% of the $73.2 billion in premiums for the segment.
- 2019 MLR rebates for the $235 billion Large Group segment were $317 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 2019 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)
Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, 5500 Employer Health Plus, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures available under Our Products or call 724-338-4100. MFA will continue to monitor enrollment changes and competitive shifts across all healthcare segments.