The ACA requires health insurers to spend a minimum percentage of their premium dollars, or MLR, on medical care and health care quality improvement.  Issuers that do not meet these minimum requirements must provide rebates to consumers. This percentage is:

  • 85% for issuers in the large group market; and
  • 80% for issuers in the small and individual group markets

Effective dates:

  • MLR data was due to HHS by July 31 for the 2019 reporting year.
  • Rebates for 2019 must be provided by September 30, 2020.

A full discussion of MLR Rebates can be found here.

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