MLR Rebate Update: Member Rosters Now Available

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. We are continuing to work toward the September 30 deadline to issue the rebate checks to these groups and will send a final communication update closer to this deadline.

As part of that effort, our Client and Account Executives will be reaching out to eligible groups soon to:

  • confirm the correct name and mailing address are on file for delivery of the rebate check
  • provide the roster of members by group who will receive the required regulatory notice of the rebate check

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

Individual & Family Plan subscribers who paid premiums in 2020 will also receive rebate checks from us. At this time, we do not anticipate rebates for our regulatory small groups – fully insured groups with 50 or fewer total employees.

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