UHC: No MLR Rebates for California Small Group

For benefit plan year 2016, the sixth Medical Loss Ratio (MLR) reporting year, UnitedHealthcare’s results show there are no premium rebates for the California Small Group market. For a summary of which states, legal entities and size of business (aggregation set) will be receiving a rebate, refer to the ​Final Rebate Summary Report.

BACKGROUND

MLR applies to fully insured group commercial plans and individual plans. The law requires insurers to spend a minimum percentage of premium dollars (80 percent for individual and small group (1-50, or 1-100 depending on the market) markets and 85 percent for large group (51+ or 101+ depending on the market) on medical services and activities designed to improve health care quality. For 2016 rebate reporting year, the following 13 states define small group as 1 – 100 and large group as 101+: Alaska, Arkansas, California, Colorado, Florida, Louisiana, Nebraska, New York, Ohio, Tennessee, Texas, Utah and Wisconsin. The Year 6 calendar year began on Jan. 1, 2016.

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