Aug 07, 2023
Florida Blue has completed calculations for the 2022 plan year, and their medical loss ratios were within CMS guidelines for all plans and segments. Therefore, there will be no MLR rebates paid for PPO, HMO, or Truli for Health.
The Affordable Care Act (ACA) requires carries to spend a certain percentage of member premiums on health care services, like doctor and hospital bills and activities that improve the quality of care, versus administrative expenses. This is called a Medical Loss Ratio (MLR). If insurers spend less than the designated amount for a particular segment, they rebate that portion back to the group administrator or member, as applicable.
The ACA sets a minimum MLR for different market segments: 80% for fully insured small groups and 85% for fully insured large groups.
Based on their calculations for plan year 2022, Florida Blue does not owe MLR rebates to any segment.
For more information, contact your Amwins Connect Regional Sales Manager.
