MLR Rebates: A Guide for Employers 54 Karen Greco / Tuesday, August 19, 2025 / Categories: Compliance Materials, ACA Materials The ACA requires health insurance issuers ("Insurers") to pay annual Medical Loss Ratio (MLR) rebates to policyholders by each September 30 if the insurer previously spent less than a specified minimum percentage of the premium on medical claims and certain healthcare quality improvement initiatives in the prior calendar year. The MLR provision is intended to limit the amount of money that insurers can allocate to administrative expenses and profits. Employers that receive MLR rebates have compliance obligations regarding the use of the rebates, which may include time-sensitive requirements to distribute to eligible plan participants (potentially including former participants) any portion of the rebate that constitutes a plan asset. This publication provides an overview of the administration of MLR rebates for fully insured employer-sponsored group health plans that are subject to ERISA. It offers information regarding Is the Rebate a Plan Asset? (Appendix A) and includes a Sample Employee Communication for notifying employees about applicable rebates (Appendix B). It also includes a section on the administration of MLR rebates received by non-ERISA plans (see under Special Rules for Church and Non-Federal Governmental Plans). Download the Guide Print Rate this article: No rating