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class="hs-search-field__bar"> <div class="block-title">Search</div> <form action="/hs-search-results"> <div class="frm_item"> <input type="text" class="hs-search-field__input" name="term" autocomplete="off" aria-label="Search" placeholder="Search"> </div> <input type="hidden" name="type" value="SITE_PAGE"> <input type="hidden" name="type" value="BLOG_POST"> <input type="hidden" name="type" value="LISTING_PAGE"> <div class="frm_btn"> <button aria-label="Search"></button> </div> </form> </div> <ul class="hs-search-field__suggestions"></ul> </div></div> </div> </div> </div> </header> </div></div> <main id="main-content" class="body-container-wrapper home-page"> <div class="container-fluid home-row1"> <div class="row-fluid-wrapper"> <div class="row-fluid"> <div class="span12 widget-span widget-type-cell " style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-1 dnd-section row1-row-0-background-layers row1-row-0-background-color"> <div class="row-fluid "> <div class="span12 widget-span widget-type-cell dnd-column" style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-2 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1724246705458" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module widget-type-rich_text" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><span id="hs_cos_wrapper_widget_1724246705458_" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_rich_text" style="" data-hs-cos-general-type="widget" data-hs-cos-type="rich_text"><h1>2023 Medical Loss Ratio (MLR) Information</h1> <p style="font-size: 20px;">Competitive premiums and consumer-friendly products make Mass General Brigham Health Plan a popular choice for high-quality and affordable healthcare coverage. Mass General Brigham Health Plan is committed to delivering affordable products and an exceptional experience for our members. This year, Mass General Brigham Health Plan is rebating a portion of premium payments for eligible members and small employers.</p></span></div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="container-fluid home-row2"> <div class="row-fluid-wrapper"> <div class="row-fluid"> <div class="span12 widget-span widget-type-cell " style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-1 dnd-section"> <div class="row-fluid "> <div class="span12 widget-span widget-type-cell dnd-column" style="" data-widget-type="cell" data-x="0" data-w="12"> <div class="row-fluid-wrapper row-depth-1 row-number-2 dnd-row"> <div class="row-fluid "> <div class="span12 widget-span widget-type-custom_widget dnd-module" style="" data-widget-type="custom_widget" data-x="0" data-w="12"> <div id="hs_cos_wrapper_widget_1724246714687" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_module widget-type-rich_text" style="" data-hs-cos-general-type="widget" data-hs-cos-type="module"><span id="hs_cos_wrapper_widget_1724246714687_" class="hs_cos_wrapper hs_cos_wrapper_widget hs_cos_wrapper_type_rich_text" style="" data-hs-cos-general-type="widget" data-hs-cos-type="rich_text"><h3 style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;">What is the Medical Loss Ratio rebate?</h3> <p style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;">Under the Affordable Care Act (ACA) and state law, insurers are required to spend a certain percentage of premium payments on medical care and healthcare quality, known as the medical loss ratio (MLR). Massachusetts has the highest MLR standard in the country, requiring 88 percent of premiums to be spent on healthcare services for individual and small groups and 85 percent for large groups. It does not apply to self-insured plans.<br><br>The MLR rebate is based on a three-year average, with the current year’s rebates representing performance from 2021 - 2023. </p> <p style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;"> </p> <h3 style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;"><span style="color: black;">Who will receive rebates for 2023?</span></h3> <p style="vertical-align: baseline; font-weight: normal;">Mass General Brigham Health Plan will provide rebates for fully insured plans offered to individuals and small employer groups with 1-50 employees (also called the merged market). For these plans, Mass General Brigham Health Plan's MLR of 86.1% was lower than the required threshold, so we are rebating the difference back to policy holders.<br><br>For large employer group plans, Mass General Brigham Health Plan met the minimum threshold, so no rebates are required. </p> <p style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;"><span style="color: #525252;"> </span></p> <h3 style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;"><span style="color: black;">How will the rebates be provided?</span></h3> <p style="vertical-align: baseline; margin-top: 0in; margin-right: 0in; margin-bottom: 3pt; padding-left: 0in; font-weight: normal;">Many of our small employers purchase their insurance directly through Mass General Brigham Health Plan. Small employers and individuals can also purchase their Mass General Brigham Health Plan insurance through intermediaries such as HSA Insurance (HSA) and the Small Business Service Bureau (SBSB) or through the Massachusetts Health Connector. Here is how rebates will be provided:</p> <p style="vertical-align: baseline; margin-top: 0in; margin-right: 0in; margin-bottom: 3pt; padding-left: 0in; font-weight: normal;"> </p> <ul> <li style="vertical-align: baseline; font-weight: normal;"><strong>Rebate checks will be provided by Mass General Brigham Health Plan</strong> to small employer groups who purchase their coverage directly from Mass General Brigham Health Plan.</li> <li style="vertical-align: baseline; font-weight: normal;"><strong>Rebate checks will be provided by Mass General Brigham Health Plan to</strong> individuals and small employer groups who purchase their coverage through the Massachusetts Health Connector.</li> <li style="vertical-align: baseline; font-weight: normal;"><strong>Rebate checks will be provided by the Small Business Service Bureau </strong>(SBSB) to individuals and small employer groups who purchase their coverage from SBSB.</li> <li style="vertical-align: baseline; font-weight: normal;"><strong>Premium credits will be provided by HSA Insurance</strong> (HSA) to individuals and small employers who purchase their coverage through HSA and are active clients. Rebate checks will be provided by HSA to individuals and small employers who purchase their coverage through HSA but terminated their coverage.</li> </ul> <p style="vertical-align: baseline; margin-top: 0in; margin-right: 0in; margin-bottom: 3pt; padding-left: 0in; font-weight: normal;"> </p> <h3 style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;">Can you share sample notices?</h3> <p style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;">Yes. Here is a <a href="https://resources.massgeneralbrighamhealthplan.org/Mass_General_Brigham_Health_Plan_MLR_Subscriber_Rebate_Letter.pdf" rel="noopener" target="_blank">sample subscriber notice</a> and a sample <a href="https://resources.massgeneralbrighamhealthplan.org/Mass_General_Brigham_Health_Plan_MLR_SmallGroup_Rebate_Letter.pdf" rel="noopener" target="_blank">small employer group notice</a>.</p> <p style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;"> </p> <h3 style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;">When will rebates be provided?</h3> <p style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;">Rebates and notices will be sent by September 13, 2024.</p> <p style="margin-top: 0in; margin-right: 0in; margin-bottom: 0in; vertical-align: baseline; padding-left: 0in; font-weight: normal;"> </p> <h3 style="font-weight: normal;"><span style="color: black;">Will subscribers be notified if their employers are receiving a rebate?</span></h3> <p style="font-weight: normal;">Yes. Subscribers whose employers are receiving a federal rebate will receive a notice in the mail postmarked by September 13, 2024.</p> <h3 style="font-weight: normal;"><span style="color: black;"></span><span style="color: black;">What responsibilities does an employer have if they receive a rebate?</span></h3> <p style="font-weight: normal;">Employers may have fiduciary responsibilities regarding use of this MLR rebate. For general information on the usage of this rebate, you may contact the U.S. Department of Labor (DOL) at (866) 444-3272 or review their guidance on this issue in this document: <a href="https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/faqs/mlr-insurance-rebate.pdf" rel="noopener" target="_blank">https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/faqs/mlr-insurance-rebate.pdf</a>. Employers also should consult with their benefit or legal advisor about this rebate.</p> <h3 style="font-weight: normal;"><span style="color: black;">Are employers who are not receiving a rebate getting notified?</span></h3> <p style="font-weight: normal;">No, only employers who will be receiving an MLR rebate for 2023 will be notified.</p> <h3 style="font-weight: normal;"><span style="color: black;">Could rebates affect taxes for employers and/or individuals?</span></h3> <p style="font-weight: normal;">Yes, rebates may have a tax impact both to employers receiving rebates and to individuals. You may want to consult with your financial and tax advisors regarding the tax impact of the rebate or contact the IRS at (800) 829-1040 or visit <a href="https://www.irs.gov/newsroom/medical-loss-ratio-mlr-faqs" rel="noopener" target="_blank">https://www.irs.gov/newsroom/medical-loss-ratio-mlr-faqs</a>.</p> <h3 style="font-weight: normal;">I have multiple policies/small group plans with Mass General Brigham Health Plan. Why did my notification only list one policy number?</h3> <p>If you have multiple policies with Mass General Brigham Health Plan, the MLR rebate was allocated toward<span style="color: red;"> </span>all your policies. 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