In accordance with the Patient Protection and Affordable Care Act (PPACA) regulations, this week Trustmark is mailing Medical Loss Ratio (MLR) rebate checks with letters to eligible groups as shown below. The size of the group is based on eligible employees.
Small group (based on state definitions, but generally groups with 50 or fewer employees): AR, AZ, GA, IL, IN, KS, MO, MT, NE, NV, OH, TN, TX, UT, VA, WV, WY
Large group (based on state definitions, but generally groups with 51+ employees): AZ, IL, IN, PA, TX, WY
Sample cover letter
Regulations under the Patient Protection and Affordable Care Act require health insurers to spend at least 80 percent of their premiums on medical expenses for small groups, and at least 85 percent for large groups, or rebate the difference to customers. A lower Medical Loss Ratio (MLR) percentage means a higher potential rebate to the employer. This requirement does not apply to self-funded plans.
Click here to view the MLR rebates Q&A.
A listing of groups and their rebate amounts was emailed to Starmark distribution partners. Groups that are not eligible are not being sent a letter.