Aug 17, 2023
If your groups had Blue Cross® Blue Shield® of Arizona (BCBSAZ) Small Group fully insured coverage in 2022, they will be receiving a rebate for a portion of their group health insurance plan premium. This rebate is part of the Affordable Care Act (ACA) and is based on the ACA’s “80/20” (medical loss ratio) rule.
In Arizona, BCBSAZ did not meet the 80/20 standard. In 2022, BCBSAZ spent only 78.3% of a total of $350,751,048 in premium dollars on health care and activities to improve health care quality. Since it missed the 80% target by 1.7% of premium it receives, BCBSAZ must rebate 1.7% of the total health insurance premiums paid by the employer and employees in your group health plan.
BCBSAZ is required to send this rebate to each employer or group policyholder by September 30, 2023, or apply this rebate to the health insurance premium that is due on or after September 30, 2023.
Active & Inactive Groups
Current and past groups that qualified for the rebate will receive a letter from BCBSAZ with all the details, including a rebate check. Members of these groups will also receive a letter making them aware of the rebate.
Disbanded Groups
Members of these groups will receive a letter from BCBSAZ with all the details, including a check for their portion of the rebate.
For individual and large group lines, BCBSAZ met MLR requirements and will not be issuing a rebate. f you have questions about this ACA-required refund, please contact your Amwins Connect Sales Representative.
