It’s MLR Rebate Time Again!
The ACA requires insurers to submit an annual report to HHS to account for plan costs. If the insurer does not meet the medical loss ratio standards, this means too large a portion of the premiums charged in the previous year went towards the insurer’s administration, marketing, and profit, rather than going toward paying claims and quality improvement initiatives. In such case, the insurer must provide rebates to policyholders. For 2023, insurers must distribute rebates to employer plan sponsors between August 1, 2023, and September 30, 2023.
Employers should keep in mind that if they receive a rebate, there are strict guidelines as to how the rebate may be used or distributed. Generally, any portion of the rebate that is considered ERISA plan assets (e.g., the portion attributable to participant contributions) must be returned to participants in some form within 90 days of receipt.
For more information, download a copy of our publication, Medical Loss Ratio Rebates: A Guide for Employers.
Paid Leave Benefits Begin September 3, 2023
August 29, 2023
Paid leave benefits will begin on September 3, 2023, for Oregon employees eligible for medical leave (for an employee's own serious health condition), family leave (caring for a family member with a serious health condition or caring for and bonding with a child in the first year after birth, adoption, or foster care placement), or safe leave (time off for survivors of sexual assault, domestic violence, harassment, and/or stalking).
Both employee and large employer (25 or more employees) contributions to the program began on January 1, 2023, and the benefits application process opened on August 14, 2023. Employers with fewer than 25 employees do not pay the required employer contribution but must collect employee contributions. Benefit amounts are based on a sliding scale using prior year’s wages earned and the state average weekly wage.
This material was created by PPI Benefit Solutions to provide accurate and reliable information on the subjects covered but should not be regarded as a complete analysis of these subjects. It is not intended to provide specific legal, tax or other professional advice. The service of an appropriate professional should be sought regarding your individual situation. PPI does not offer tax or legal advice. "PPI®" is a service mark of Professional Pensions, Inc., a subsidiary of NFP Corp. (NFP). All rights reserved.