Mark Farrah Associates Analyzed the 2023 Medical Loss Ratio and Rebates Results

In the latest Healthcare Business Strategy report, Mark Farrah Associates, www.markfarrah.com, summarized key findings from the 2023 MLR report released by the Department of Health and Human Services (HHS). The Affordable Care Act’s (ACA) MLR provision requires health insurers who fail to spend specified percentages of their health care premium income to pay rebates to their customers. The goal of this provision is to curb growth in health care premiums while ensuring that plans are adequately covering healthcare expenses. This brief focused on health plan performance as it relates to the 2023 Medical Loss Ratio, and the related rebates subsequently due to consumers.

Key highlights include:

• In 2023, rebates to consumers have dropped slightly to $957 million, benefiting 5.8 million customers, equating to approximately $156 per beneficiary.
• For 2023, Pennsylvania, led the country again with over $126 million in MLR rebates, down 43% from 2022.
• 2023 MLR rebates paid for the Individual segment were $463 million, which is .38% of the $123 billion collected in premiums.
• MLR Rebates for the Small Group segment in 2023 were $299 million, or 0.41% of the $74 billion segment premiums.
• 2023 MLR rebates for the $262 billion Large Group segment were $195 million.

Subscribers to Mark Farrah Associates' Health Coverage Portal and the SHCE and MLR Data have access to this dataset with the benefit of NAIC company codes mapped to HIOS codes used for government reporting by health plans. To read the full text of "A Brief Summary of the 2023 Health Insurance Medical Loss Ratio and Rebates Results", visit the MFA Briefs on Mark Farrah Associates' website.

About Mark Farrah Associates (MFA)

MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include: Health Coverage Portal™, Medicare Business Online™, Medicare Benefits Analyzer™, County Health Coverage™, Health Plans USA™ and 5500 Employer Health Plus. Follow us on LinkedIn!

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