PCORI Fees and MLR Rebates

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Are you managing MLR rebates & PCORI fees correctly?

The Affordable Care Act (ACA) requires health insurers to meet Medical Loss Ratio (MLR) standards, ensuring that most premium dollars go toward health benefits—not administrative costs. When insurers don’t meet these standards, they must issue MLR rebates to policyholders. But how should employers handle these funds?

While PCORI fees help fund critical research on healthcare outcomes, many employers are unsure of their payment obligations.

Join us for a deep dive into these ACA requirements where Sara Simkins will cover:
     • MLR rebates – what they are and how they impact employers
     • How employers can distribute MLR rebates
     • PCORI fees – what they fund and who is responsible for paying them
     • How PCORI fees are calculated and reported

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