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Wellmark In Compliance with 2012 MLR Requirement

Health insurance companies across the country are in the process of issuing rebates to policyholders in order to be in compliance with the Medical Loss Ratio (MLR) requirement of the Affordable Care Act (ACA).


The MLR represents the percentage of each premium dollar spent by the health plan to pay for health care claims and improved quality rather than  spending for administrative expenses, marketing costs, and profit. Under the ACA, plans are not required to issue rebates if they have an MLR of 85 percent for large groups (51+ employees), and 80 percent for small businesses and individual policyholders.


Wellmark has met and exceeded the MLR requirements for 2012 in all market segments in both Iowa and South Dakota — meaning Wellmark will not be required to issue rebates.

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