Sarah Borders July 31, 2026 2 min read

Health Insurers Expected to Distribute $234 Million in MLR Rebates to Employers

Each year, health insurers must calculate their Medical Loss Ratio (MLR) for their fully insured individual, small group, and large group medical/Rx book of business in each state. If their 3-year average MLR shows the carrier collecting more in premium than is allowed under the Affordable Care Act (ACA), the excess for that state’s segment must be returned to policyholders (in the individual market) or plan sponsors (in the group market) by the following August.

The Kaiser Family Foundation (KFF) has analyzed data to estimate insurers are expected to issue $759 million in MLR rebates next month. The lion’s share (almost $525 million) will go to individual policyholders, leaving an estimated $121 million going to small group plan sponsors and $113 million to large group plan sponsors.

Employers receiving MLR rebates have a responsibility to determine how much might belong to plan participants (and former participants) and distribute what belongs to them within 90 days.

Applies to:

Employers with fully insured medical plans during one or more of the last three calendar years.

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Sarah Borders

Principal, Benefits Compliance Solutions. Sarah has spent the last 15 years in the employee benefits industry, has numerous designations and serves on NAHU’s Employer Working Group Subcommittee and is an active board member of Austin AHU. She recently stepped down as Vice President of Benefits Compliance at one of the nation's largest brokerage firms to start her own compliance consulting practice. Her designations include an active license with the Texas Department of Insurance, CEBS (Certified Employee Benefits Specialist), Certified Health Care Reform Professional, HIPAA certification and Health Care Service Associate. She holds an MBA from Texas A&M Corpus Christi and a BA from University of Incarnate Word. Her consulting firm, Benefits Compliance Solutions, partners with employers to identify unknown risks and avoid hundreds of thousands of dollars in fines and lawsuits from failure to comply with their healthplan obligations.

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