3 ACA rebate updates to watch in 2025

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Insurers have until Sept. 30 to issue ACA Medical Loss Ratio rebates for 2024. The Medical Loss Ratio mandates insurance companies spend at least 80% or 85% of their premium dollars on medical care, not administrative expenses or profits. If a company does not meet this requirement, it will have to pay back its members the following year.

Becker’s has been tracking how much insurance companies owe. 

Here are three moves to watch:

  1. UnitedHealthcare is set to return $359 million in rebates by the deadline.
  2. Massachusetts approved $75.6 million in rebates from BCBS Massachusetts, Fallon Health, Harvard Pilgrim Health Care, Mass General Brigham Health Plan and UnitedHealthcare. The rebates span over 350,000 people.
  3. Centene subsidiary Ambetter from Home State Health will pay Missourians $87.5 million.

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Register to Attend Webinar

Read. Deleted. Ignored. What It Takes to Drive Behavior Change and Lower the Cost of Care

Tuesday, August 4
11:00 AM - 12:00 PM CDT

Presenters: Koleen Cavanaugh, Independence Blue CrossBukata Hayes, HMO Minnesota (Blue Plus)Nathan Foco, Select HealthTrish Cox, SCAN Health PlanJonas Puente, ZS Associates

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