2025 Medical Loss Ratio rebates issued for Premera Blue Cross HMO plans
Premera has issued Medical Loss Ratio (MLR) rebate payments to eligible PBC HMO group plan policyholders based on federal MLR calculations for the 2025 reporting year.
Under the Affordable Care Act (ACA), health insurers must spend a minimum percentage of premium dollars on medical care and activities that improve health care quality rather than administrative expenses. The required thresholds are:
- 80% for individual and small group markets
- 85% for large group markets
If an insurer does not meet these thresholds after applying federal MLR calculation rules, it must provide rebates to affected policyholders.
2025 MLR results
Based on federal MLR calculations for the 2025 reporting year, Premera is required to issue rebates equal to 1.1% of eligible premium contributions to eligible PBC HMO group plan policyholders.
Rebate payments, along with letters explaining the rebate, were distributed on September 22, 2026.
What employer groups should know
Employer groups that receive an MLR rebate may have obligations regarding the use or distribution of rebate funds. Groups with questions should consult their legal, tax, and benefit advisors to understand any responsibilities under applicable laws and regulations.
Learn more
Additional information about Medical Loss Ratio requirements is available through the Centers for Medicare & Medicaid Services.