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⚠️⚠️⚠️ ADVANCE WARNING: Long wonky MLR rebate thread ahead! All 50 states + DC!
One of the provisions of the #ACA is the “Medical Loss Ratio” provision, which requires health insurance carriers to spend a minimum of 80% or 85% of their premium revenue on actual healthcare/medical claims. It’s 80% for the Individual & Sm. Group markets, 85% for Lg. Group. 1/
Simple version: If an insurance carrier spends *less* than 80% (85%) on medical claims, weighted over a 3-year average, they have to *pay back* the excess to the policyholders.
So, if they bring in $100M in premiums & only pay out $75M in claims, they have to rebate $5M. 2/
So, if they bring in $100M in premiums & only pay out $75M in claims, they have to rebate $5M. 2/
📣 NEW: How much of a Risk Corridor rebate check might YOU receive? (thread)
acasignups.net/19/06/26/fun-r…
acasignups.net/19/06/26/fun-r…
When the #ACA was passed, the Obama Admin & Congressional Dems knew that things would be pretty rocky the first few years, so they included several market stabilization programs to try and minimize the insanity. One of these was called “Risk Corridors”. 2/
The Risk Corridor program sounds confusing, but the simple version is this: For the first 3 years, insurance companies which did unusually WELL had to pay a portion of their profits into a central kitty… 3/
