The Medical Loss Ratio obligations under the ACA cap the percentage of premium dollars health insurers may use for administration, marketing, and profits. If a health insurer collects more than the allowed amount for these spending categories, they must provide a rebate to affected groups. A few of the medical carriers have recently sent out Medical Loss Ratio (MLR) rebates, so it’s important to know what can be done with that money. If employees paid any portion of the monthly premiums, employers will likely need to share the rebate with them.

Fall River has written in past articles about how Health Reimbursement Arrangements (HRAs) can be a valuable cost-containment strategy while effectively rendering employees’ benefits unchanged. We recently completed an internal analysis of one client who was able to slash their effective renewal increase down from 15% to 5% by adjusting and expanding their HRA.