[UCRDBR] U.S. Behavioral Health Plan, California – 2022 Optum Health Insurance Premium Rebate Letter

[Departmental Benefits Representatives]

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October 2, 2023

To:
Department Benefit Representatives
From:
Central HR Benefits Office
Re:
U.S. Behavioral Health Plan, California – 2022 Optum Health Insurance Premium Rebate Letter


DBRs please distribute to your internal list serv.

Optum Behavioral Health will send the U.S. Behavioral Health Plan, California 2022 Optum Health Insurance Premium Rebate<https://hr.ucr.edu/sites/default/files/2023-10/subscriber_notice_sample_large_usbhpc_0.pdf> letter to the 2022 plan year subscribers of Kaiser Permanente HMO the week of September 25-29, 2023.  These subscribers will receive this letter because they had Optum Behavioral Health (Group 11280) benefits coverage in 2022.

UC will post the attached standalone Medical Loss Ratio FAQ<https://hr.ucr.edu/sites/default/files/2023-10/2022_medical-loss-ratio-faq-20230919_0.pdf> on UCnet, which has been updated for the 2022 rebate.

The Affordable Care Act requires insurance companies to use a certain amount of premium dollars to provide services.  If they don’t use that amount, the excess must be reimbursed as a rebate to the employer, and plan members must be notified of the rebate.  Please note that the Medical Loss Ratio is calculated across all Optum’s plans in a state and is not based solely on UC members’ utilization.

As in prior years, UC decided to apply the member portion of the 2022 Optum Behavioral Health MLR rebate toward lowering future premium contributions, which resulted in a reduction to the 2024 Kaiser/Optum Behavioral Health overlay employee contributions.
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