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For the third year, employers who sponsor an insured group health plan may be receiving a Medical Loss Ratio (MLR) rebate from their insurers. Self-funded medical benefit plans are not subject to these requirements. The rebates raise several fundamental questions for employers including:

• How much (if any) of the rebate must be distributed to plan participants?
• How quickly must I distribute the participants’ share?
• What options do I have in distributing the employees’ share?
• What are the tax consequences of the various distribution options that are available?

International coverage for P&C related risks is largely about ensuring regulatory compliance, assuming the appropriate coverage is included in a master or global insurance program.