MLR

We find that insurers estimate they will issue a total of about $1 billion in Medical Loss Ratio (MLR) rebates this year across all commercial markets under a provision of the Affordable Care Act (ACA) that limits the share of premiums that insurers can keep for administration, marketing, and profits.

Private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under an Affordable Care Act provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three…

Private insurance companies expect to pay $2.1 billion in rebates to consumers in 2021 due to excessive premiums in recent years.

New data from 2019 suggest that insurers in the individual market remain profitable, even with average premiums falling for the first time since the ACA was implemented. These data indicate that the individual market appears to be stable in 2019, despite the repeal of the individual mandate penalty and the proliferation of loosely-regulated short-term insurance plans.

Private insurance companies expect to pay a record of $2.7 billion in rebates to consumers in 2020 due to excessive premiums in recent years – nearly double last year’s then-record total.

We estimate insurers will be issuing a total of at least $1.3 billion in MLR rebates across all markets – exceeding the previous record high of $1.1 billion in 2012, due in part to the record profits insurers made in 2018. The amount varies by market, with insurers reporting at least $743 million in the individual market, $250 million in the small group market, and $284 million in the large group market.

Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers, according to a new KFF analysis. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or…

Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.

Insurers in 2017 had their best financial year selling individual market health insurance since the Affordable Care Act began requiring guaranteed access to coverage for people with pre-existing conditions in 2014, though recent political and policy changes create new challenges for insurers trying to succeed in this market, new Kaiser…