June 18, 2013
The Medical Loss Ratio (MLR) standard of the Affordable Care Act requires health insurance companies to devote 80 or 85% of the premiums they collect to provide health care services to customers, after subtracting taxes and regulatory fees. If an insurer does not meet the MLR standards, it may pay rebates to its customers.
As a result of, among other things, strong expense management, collaboration with providers, and business innovations, Blue Cross and Blue Shield of Oklahoma (BCBSOK), a division of Health Care Service Corporation, met or exceeded the MLR requirements for the vast majority of our customers in 2012.
Policy holders with individual health care coverage or small group health plans with up to 50 employees will receive notification as to the exact amount of any rebate. For those customers that will receive rebates, at this time, we anticipate that the one-time rebate may range anywhere from $5 to possibly a few hundred dollars this year. Given the inherently unpredictable nature of health care costs and utilization, it is not surprising that health plans may pay rebates to some customers in certain markets.
BCBSOK is part of a customer-owned organization that reinvests earnings to benefit the health and wellness of its customers. We set our sights on meeting the health care needs of our customers and facilitating their use of the health care system.
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