Under the Affordable Care Act (the Act), fully insured health plans and issuers are subject to new standards requiring a minimum percentage of premium dollars to be spent on medical claims, clinical services and activities designed to improve health care quality. As a result, on a calendar year basis, insurers must achieve a medical loss ratio (MLR) of 80 percent for individual and small group markets, and 85 percent for large group markets.
UHC California Small Group MLR Information
For California fully insured small business groups, UnitedHealthcare Benefits Plan of California, which includes Select Plus, Core, Doctors Plan, and Non-Differential PPO plans, will receive a rebate. UHC HMO and Navigate are not included and will not receive a rebate as they met or exceeded MLR requirements.
See UHC's 2023 Medical loss ratio final payout report - group (PDF) for additional states, markets, and legal entities.
For more information, see the following resources from UHC:
For questions or help with a UHC quote, please contact a member of your B&P Sales Team – 888.722.3373.