MI| Bulletin 2025-13-INS, issued by the Michigan Department of Insurance and Financial Services on May 20, 2025, outlines the filing requirements for health insurers regarding Medical Loss Ratio (MLR) reporting in accordance with MCL 500.3406jj, enacted through Public Act 254 of 2024. Health insurers subject to the Affordable Care Act’s MLR and rebate requirements must annually submit MLR data to the U.S. Department of Health and Human Services (HHS) by July 31 following the reporting year, using prescribed forms.
Key Points:
- Insurers are also required to file the same MLR calculations, rebate information, and supporting materials concurrently with the Michigan DIFS via SERFF under “Statutory Reporting.”
- Any amendments made to submissions with HHS must also be promptly filed with DIFS.
- The requirements do not apply to health plans exempt from ACA rebate provisions or to grandfathered plans as defined in federal regulations.