Include:
Medicare Advantage Part C and Medicare Part D plans subject to the Medicare
MLR requirements pursuant to section 1857(e) of the Social Security Act.
Column 43
Uninsured (Self-Funded) Plans
Include:
Plans for which a reporting entity, as an administrator, performs administrative
services such as claims processing for an employer that is at risk, and accordingly,
the administrator has not issued an insurance policy.
Report the experience of the issuer’s Uninsured (Self-Funded) Plans for the MLR
reporting year as of December 31, as reported to the regulatory authority in the
issuer’s State of domicile or as filed on the NAIC SHCE filing for the MLR
reporting year.
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