Maryland: Group plan enrollees to receive $59.3 million in 2018 MLR rebate payments

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 Maryland:

Last year Maryland had no Individual Market rebates, and this year it's a nominal amount...just $25,000 going out to fewer than 1,000 people.

The numbers on the group markets, however, are pretty eye-raising: $29.4 million in the Small Group Market and nearly $30 million for the Large Group...and these are actually down from last year. Huh.

In 2020, on the other hand, there could be a solid Indy Market rebate of as much as $7.6 million, due specifically to CareFirst of Maryland raising their rates 17.7% this year. This struck me as odd given that they already ran a 73.4% MLR in 2018 and that the state implemented a robust reinsurance program (which caused CareFirst BlueChoice to drop their rates by over 22%), but it is what it is; we'll see:

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.