Aetna: Medical Loss Ratio (MLR) Letter for Plan Sponsors

​Aetna needs to know the total average employee (TAE) count for plan sponsors in order to comply with the Affordable Care Act (ACA). Therefore, Aetna is sending letters about health care reform and MLR requirements to a targeted group of plan sponsors. 

BACKGROUND

The ACA sets rules about how much plans must spend each year on medical care and activities that improve health care quality. These are known as the minimum MLR rules. If Carriers do not spend the minimum amount required, they must provide a premium rebate. 

The required MLR varies for small and large groups. 

NEXT STEPS 

Aetna mailed a letter on January 23, 2017, to their plan sponsors with insured medical products and less than 200 eligible employees, and asked for their TAE count for calendar year 2016. Aetna will use this information to place the plan sponsor in the right pool for MLR reporting and rebate administration (2017 experience year). 2017 experience year rebates will be paid in 2018. 

The plan sponsors who do not respond will receive up to two follow-up letters. Aenta will provide specific instructions for plan sponsors to reply through an online portal at www.aetna.com. OR, they can respond by mail using the paper response card and postage-paid envelope provided in the letters. Aetna is requesting all responses by April 27, 2017. The same process was used last year with plan sponsors. 

Please don't submit the TAE on behalf of your plan sponsor.

For questions, please ​contact a member of your B&P Sales Team - 888.722.3373.