Kansas: If my data is accurate, 17,000 Sunflower State enrollees should be getting MLR rebate checks averaging $1,500 apiece!

MLR rebate payments for 2018 are being sent out to enrollees even as I type this. The data for 2018 MLR rebates won't be officially posted for another month or so, but I've managed to acquire it early, and after a lot of number-crunching the data, I've recompiled it into an easy-to-read format.

But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:

  • First, I assumed total enrollment for each carrier remains exactly the same year over year.
  • Second, I assume the average 2019 rate changes I recorded for each carrier last fall are accurate.
  • Third, I assume 2019 is seeing a 5% medical trendline on average...that is, that total 2019 claims per enrollee will be 5% higher than 2018's.

All three of these are very questionable, of course, but they at least provide a baseline.

All that being said, here's what the payments for 2018 going out this month look like in Kansas:

The Small and Large Group markets look pretty standard, coming in at $765,000 and $952,000 in MLR rebates respectively.

On the Individual Market, however, there's a hell of an outlier...and my data source on this one is questionable as well, so I'm flagging it in orange. IF the data for Sunflower State Health Plan, Inc. (another Ambetter rebranding) is accurate, however, it means that they have to pay out a whopping $25.5 million in rebates. This isn't the largest payout from a single carrier...but Sunflower State only has around 17,000 enrollees, meaning the average rebate amount is a whopping $1,476 per person. Again, that's the average...some older enrollees could see as much as $3,000 apiece.

Again, I'm putting an asterisk next to the Kansas number due to some questions about the reliability of the data on Sunshine's dollar amount.

Assuming this is accurate, however, next year could see an even bigger rebate payout from Sunflower:

AGAIN: There's absolutely no guarantee that things will play out this way. It's possible that none of these carriers will make MLR payments next year, or only some of them will, or the amounts will be smaller. These 2019 projections are pure speculation on my part based on a number of big assumptions.