Expanded women’s preventive health benefits for plans that renew on or after August 1st now include services such as prenatal visits, certain contraceptives (specific religious organizations may be exempt), screening/counseling for domestic violence, and screening for gestational diabetes.
Medical Loss Ratio Rebates
In short, insurers are required to issue rebates by August 1st for the 2011 plan year. Under the Patient Protection and Affordable Care Act (PPACA), the insurance carriers are required to satisfy certain medical loss ratio thresholds, spending 80-85% of premium dollars on medical care and health care quality improvement. The carriers are required to make the first rebates to consumers in 2012 based upon their 2011 MLR and must be paid by August 1st of each year. Rebates are issued to employers with an accompanying letter with Federally-mandated language. Federal regulations require the insurance company to send letters to each employee alerting them that a rebate is being sent to the employer. Where employers pay premium on behalf of employees, the rebate remains with the employer. For premiums or portions of premiums paid by the employees, there are three ways for enrollees to receive rebates: by having premiums reduced, by means of a rebate check or, if premiums were paid by credit card, by a lump-sum credit to that credit card.