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Independence Blue Cross's (Independence) federal MLR in 2021 was below the required minimums for a number of segments. As a result, we will issue affected customers and subscribers a rebate of a portion of paid premiums during the 2021 reporting year. The following customers and subscribers will be receiving rebates:
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- QCC individual subscribers and small and large group fully insured customers
- Keystone Health Plan East individual subscribers and small and large group fully insured customers
- AmeriHealth PA small and large group fully insured customers
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Check and notification mailings by September 30
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Before the end of September, Independence will mail impacted group customers and individual subscribers their rebate checks. Included with each check are a required CMS notice, cover letter, and FAQ. Group rebates will be distributed at the plan level, so customers may receive more than one rebate check if they offered more than one plan for 2021.
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In addition, as required by CMS, group subscribers will also receive notification that their group/employer is receiving a rebate. (Subscribers that are part of groups that are ERISA exempt but did not provide proper verification and groups that are no longer in business, will receive rebate checks directly.)
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Here are samples of the letters and notice we are sending to groups and subscribers:
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About MLR rebates
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The Affordable Care Act requires that all health insurers spend a percentage of each premium dollar received towards paying claims, clinical services, and activities that improve health care quality for members. This percentage is known as the minimum medical loss ratio.
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If a health insurer does not meet this MLR requirement, the insurer is required by law to issue rebates to employer groups and/or plan subscribers. As a reminder, self‑funded commercial group health plans are not subject to MLR rules.
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Customer service is available
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Our dedicated MLR customer service team will be prepared to help assist customers and subscribers with any MLR rebate‑related questions and are available via these helplines:
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- Independence and AmeriHealth PA customers, as well as brokers, may call 1-888-379-7435 to speak with a dedicated customer service representative about their rebate check, CMS notice, letter, and FAQs.
- Independence subscribers may call 1-888-745-2314 to speak with a dedicated member services representative about the CMS notice, letter, and FAQs.
- AmeriHealth PA subscribers may call 1-888-379-7435 to speak with a dedicated member services representative about the CMS notice, letter, and FAQs.
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Impacted parties can also visit cms.gov for more information about MLR requirements.
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