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May 25, 2021
Small Groups in Nevada will receive incremental medical loss ratio (MLR) rebates as a correction to rebates issued for the 2018 plan year. Anthem will issue the rebates by May 31, 2021.
Nevada Small Group rebates We recently reviewed previously paid rebates and identified $32,172 in additional MLR rebates that we should have included in 2018 rebate checks issued to Nevada Small Group customers in September 2019. All 133 originally paid Small Group customers will receive incremental rebate checks, plus a proportional amount of $6,077 in total CMS-required interest, in May 2021. The average total rebate check per impacted group is $242.
About MLR rebates The Affordable Care Act (ACA) encourages health plans to spend most of the premium dollars they collect on healthcare costs rather than overhead. The ACA’s MLR provision requires plans in the fully insured Small Group and Individual markets to spend at least 80% of premium income on healthcare claims and quality improvement. In the fully insured Large Group market, it requires at least 85% of premium be spent on claims and quality improvement. In markets where we don’t meet the minimum ratio, we’re required to issue rebates to employer groups and Individual members. ASO plans and stop-loss insurance are excluded from the rebates.
If you have questions, please reach out to your Anthem representative.
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