Medical Loss Ratio Rebates for 2020 Tax Year

Federal law requires that we spend a certain percentage of fully insured plan premiums on medical care. If we spend less during the three-year lookback period, we refund that money back to our customers.

Based on our preliminary assessment, we anticipate that all Optima Health regulatory large group clients—fully insured groups with 51 or more total employees—who paid premiums in 2020 will receive a premium rebate check from us. In addition, Individual & Family Plan subscribers who paid premiums in 2020 will receive rebate checks from us.

At this time, we do not anticipate rebates for our regulatory small groups as a larger percentage of premiums was spent on healthcare services for 2020.

We will continue to provide updates as we complete our analysis to meet the September 30 deadline to issue the rebate checks.

If you have any questions, please contact your Optima Health representative.