[Ucrea] Optum U S Behavioral Health Insurance Premium Rebate Letter

[Cristina L Otegui]

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October 6, 2022
To:
UCR Emeriti & Retirees

From:
UCR Benefits Office on Behalf of UC Office of the President (UCOP)

Re:
Optum U S Behavioral Health Insurance Premium Rebate Letter

Optum Behavioral Health issued the 'U.S. Behavioral Health Plan, California 2021 Health Insurance Premium Rebate' letter to 2021 non-Medicare plan subscribers of Kaiser Permanente HMO. The letter may be viewed at: https://emeriti-retirees.ucr.edu/document/subscriber-notice-sample. These subscribers will receive this letter because they had Optum Behavioral Health (Group 11280) benefits coverage in 2021.

The standalone FAQ is also posted on UCnet and has been updated for the 2021 rebate. The FAQ can be viewed at: https://emeriti-retirees.ucr.edu/document/2021-medical-loss-ratio-faq-2022.

The details of the rebate and membership are as follows:

*        45,480 subscribers

*        $876,638.84 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 communicated previously, UC decided to apply the member portion of the 2019 and 2020 Optum Behavioral Health MLR rebates toward lowering future premium contributions, which resulted in reductions to the 2022 and 2023 Kaiser/Optum Behavioral Health overlay employee/retiree contributions, respectively. To remain consistent in our approach, we will apply the member portion of the 2021 MLR rebate toward lowering future premium contributions as well.







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