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Metal Levels for Qualified Health Plans

GoldBeginning in 2014, the Affordable Care Act (ACA) requires health plans offered through an Exchange, or qualified health plans (QHPs), to meet certain levels of actuarial value. ACA’s required actuarial value levels are referred to as “metal levels”—bronze, silver, gold and platinum.   ACA’s metal levels are intended to allow consumers to compare plans with similar levels of coverage in order to help them make informed decisions about their health insurance coverage.

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Rebates, Rebates, Rebates

Medical Loss Ratio Rebates and Notifications 

The 2012 Medical Loss Ratio (MLR) have been calculated!  The MLR is 85 percent for issuers in the large group market and 80 percent for issuers in the small and individual group markets. Issuers that do not meet the applicable MLR standard must provide rebates to consumers.

Not all carries met the MLR thresholds, Blue Cross Blue Shield of Arizona, United Healthcare did not, but Healthnet of Arizona did.

As an Employer, what should you do if you receive a check? (more…)