Tag: Medical Loss Ratio

Question: How does ACA impact smaller employers with less than 50 employees? Answer: Many of the provisions of the Affordable Care Act apply to larger employers (with more than 50 or 100 employees).  Here is a summary of some of the provisions of the law that impact under 50 employers from the Kaiser Family Foundation: Small Business…

Question: How is reporting of the MLR being handled with respect to the 5500 filing?  Will it require an amended Schedule A for 2011 or a new one in 2012? Answer: In accordance with ERISA, Schedule A (“Insurance Information”) sets forth required information about a specific group insurance policy with respect to a specific policy…

Question:  How should clients handle the Medical Loss Ratio (MLR) rebates for employees who have terminated employment with the company? Answer: The guidance issued by the Department of Labor is that an employer’s allocation of the rebates should be “impartial and in the interest of participants,” for purposes of ERISA section 404(a)(1), even if it…

Question:  How do we handle the employee distributions from the carriers for Medical Loss Ratio (MLR) rebates? Answer: The Medical Loss Ratio (MLR) is the percentage of premium that the insurance carrier spends on health care. Generally, the MLR is the amount spent on medical care (claims, clinical services and quality-improvement activities) divided by the…