[UCRDBR] U.S. Behavioral Health Plan – 2023 Optum Health Insurance Premium Rebate Letter

[Departmental Benefits Representatives]

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September 19, 2024


To:
Department Benefits Representatives
From:
HR Central Benefits Office
Re:
U.S. Behavioral Health Plan – 2023 Optum Health Insurance Premium Rebate Letter
_____________________________________________________________________________________________________
DBRs, please share this information via your internal listserv.  Do not reply to this email.  Please send a separate email with questions to benefits at ucr.edu<mailto:benefits at ucr.edu>.

Optum Behavioral Health is sending the U.S. Behavioral Health Plan, California 2023 Health Insurance Premium Rebate<https://documents.ucr.edu/HR-Benefits/benefits-Behavioral-Health-Plan-2023-Health-Insurance-Premium-Rebate.pdf> letter to non-Medicare plan subscribers of Kaiser Permanente HMO.  The subscribers will receive this letter because their membership with Optum Behavioral Health (Group 11280) benefits coverage in 2023.  While the contents of the PDF may appear to include two letters and an FAQ, it is intended to be a cover letter, FAQ, and formal letter.  The entirety of the PDF will be sent to each subscriber.

UC will post the attached standalone FAQ on UCnet, which has been updated for the 2023 rebate.

The details of the rebate and membership are as follows:

  *   Subscriber count: 34,516
  *   $1,021,409.01 total rebate amount

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 will apply the member portion of the 2023 Optum Behavioral Health MLR rebate toward lowering future premium contributions, which resulted in a reduction to the 2025 Kaiser/Optum Behavioral Health overlay employee/retiree contributions, respectively.

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