Exclusive! Nevada: 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 Nevada:

There's one oddity here, howevrer: SilverSummit Healthplan, Inc. had over 23,000 ACA exchange enrollees last year, but for some reason their dataset for 2018 doesn't list any MLR percentage, rebate amount or any amounts at all for premiums paid or claims processed. I don't mean the amounts are $0, I mean they're completely missing, which is of course impossible given that they had 23,000 Nevadans enrolled. The odds are they don't owe any rebates this year, but it's still a head-scratcher.

  • Large Group market rebates increased dramatically, from just $19,000 last year to nearly $1.2 million this year
  • Small Group market rebates increased from $6.4 million to $7.5 million
  • Nevada didn't have any MLR rebates on the Individual market last year, and only has nominal rebates of $10,000 to a few hundred people this year.

For 2020, individual market rebates could potentially increase to perhaps $360,000:

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.