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MLR Answers To Your Questions

Sep 05, 2012

Two additional Medical Loss Ratio notices will be distributed the week of 9/4:

 

These materials will enable you to respond to your customers' inquiries.

In this communication you will find:

Sample letters:

FAQs

Notice of MLR (Medical Loss Ratio) Information

Why? Federal regulatory guidance was released in May and applied to the 2011 MLR reporting year. This notice is required when there was no premium rebate for the 2011 experience year.

Who? The required notice will be sent to policyholders and subscribers of a group health plan, and each subscriber in the individual market whose plans were not eligible for a premium rebate for the 2011 MLR experience year with the following exceptions. The notice is not required to be sent to mini-med or expatriate policyholders or subscribers. Additionally, the notice is not required to be sent to policy-holders and subscribers in non-credible pools. Click here for the pools impacted by Notice of MLR information. Contact your field sales representative for those plan sponsors and subscribers impacted.

What? Click here for a sample of the Aetna cover letter and the required Notice of MLR information.

Notice of Rebate Package for employees added in 2012

Why? Federal guidance released on July 17, 2012 requires that Aetna distribute a Notice of Rebate to any new employees that were added to a rebate eligible pool in 2012 and were still active as of 7/31/2012. This is also referred to as a "catch up" notice.

Who? The Notice of Rebate will be sent to new employees who were added between 1/1/12 and 7/31/12 to a rebate eligible plan and were still active as of August 1, 2012. Contact your field sales representative for those plan sponsors impacted. You may also call 1-855-697-7509 for general questions.

What? Click here for a sample of the Aetna cover letter and the required Notice of Rebate.

Aetna is happy to partner with you and hear your feedback on how improve this process for next year. If you have feedback to share, please reach out to your field sales contact. We hope you find the Minimum MLR information on our website helpful.

Please contact your b&p Group Representative to discuss the details above- 888.722.3373.

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