Exclusive! Arizona: 2018 MLR Rebate Payments (& potential 2019 rebates)

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 months look like in Arizona:

  • Large Group market rebates dropped from $7.3 million down to $4.7 million
  • Small Group market rebates dropped from $4.0 million down to $2.5 million
  • Individual market MLR rebates skyrocketed from 101,000 enrollees receiving $16.2 million last year to 96,000 receiving a whoping $92.3 million...averaging $959 apiece!

Nearly all of this comes from Health Net of Arizona...operating under the "Ambetter from Arizona Complete Health" (Ambetter, aka Centene, bought out Health Net last year...confused yet?).

I was given a heads up about the insanely high MLR rebates by this person:

Got a 14% rebate from Ambetter of Arizona today. https://t.co/YThphyr3Kv

— Quetzalcoatl Cortes (@QCortes) September 7, 2019

When I queried further, he/she sent me a screen shot of the actual letter sent with the rebate check:

For 2020, individual market rebates could potentially increase further, to as much as $104 million:

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.