by Jinghong Chen

Insurers that participate in the individual, small-group and large-group markets will issue a record high $2.5 billion in medical loss ratio (MLR) rebates to more than 11.2 million customers this year, an increase of almost $1.1 billion from rebates issued last year, according to CMS. Because health care utilization remains depressed, many health insurers are thriving amid the coronavirus pandemic. Several insurers have waived costs for COVID-19 treatments and offered up premium credits to lower the MLR rebates they could owe over the next couple of years (HPW 10/30/20, p. 1), as MLR rebate amounts are calculated on a rolling three-year average.

NOTE: Rebates for 2019 are based on MLR reports filed through Oct. 16, 2020.

SOURCES: “2020 Medical Loss Ratio Rebates,” Kaiser Family Foundation. Visit https://bit.ly/2zosGOH. CMS, visit https://go.cms.gov/38B1bky, https://go.cms.gov/36suLWz and https://go.cms.gov/3loeY1n.