Health insurance rebate checks, often called Medical Loss Ratio (MLR) rebates, are given to individuals or employers when their insurance company spends less than a required percentage of premiums on medical claims and healthcare quality improvement. For 2025:
- Individuals with individual insurance policies who are eligible will receive rebate checks directly from their insurance company.
- For those covered by small or large group employer health plans, rebates are usually paid to the employer, who may then distribute them to employees depending on how premiums were paid.
- These rebates occur because insurance companies must spend at least 80% of premiums on medical costs and quality improvements for individual and small group plans, and at least 85% for large group plans. If insurers spend less, they return the difference as rebates.
- Employers must distribute any rebates that correspond to employee contributions within about 90 days, either as premium reductions for future coverage or cash refunds.
Thus, recipients of these health insurance rebate checks are individuals with eligible individual insurance plans and employees of companies whose group plans generated rebates, depending on employer distribution policies. Rebates for 2025 plans are typically issued by late September 2025.
