---
title: Banner Health and Aetna Health Insurance Company — Medical Loss Ratio & rebates (Arizona, 2024)
license: CC0-1.0
source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year
---

# Banner Health and Aetna Health Insurance Company — Medical Loss Ratio & rebates (Arizona, 2024)

Medical Loss Ratio and rebate outcomes for Banner Health and Aetna Health Insurance Company (parent group: CVS Health Group, as reported) in Arizona, 2024 MLR reporting year, by market: small group 79.9%, large group 87.1%. Owed $59,218 in rebates. RECORDED CMS-published MLR / standard / premium / rebate; rebate-as-%-of-premium is DERIVED. A spending ratio across the whole book in a market — not plan quality or advice. CC0.

## Claims

### Banner Health and Aetna Health Insurance Company spent 79.9% of small group premiums on care in AZ (2024) → $59,218 rebate

**RECORDED.** In the Arizona small group market, Banner Health and Aetna Health Insurance Company's three-year credibility-adjusted Medical Loss Ratio was 79.9% against the 80% floor, on $61,857,105 of 2024 premium earned. It fell below the floor and owed $59,218 in rebates (≈$6 per enrollee). RECORDED CMS-published figures (occurred=true; an actual backward-looking ratio insurers report under the 80/20 rule, adjudged=TRUE — CMS published it); rebate-per-enrollee is a DERIVED sub-figure.

Source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year — https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio
Falsifier: A RECORD of measured/reported events (occurred=true) from CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year; superseded when CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year publishes its next release.

### Banner Health and Aetna Health Insurance Company spent 87.1% of large group premiums on care in AZ (2024)

**RECORDED.** In the Arizona large group market, Banner Health and Aetna Health Insurance Company's three-year credibility-adjusted Medical Loss Ratio was 87.1% against the 85% floor, on $146,599,369 of 2024 premium earned. It met the floor; no rebate owed. RECORDED CMS-published figures (occurred=true; an actual backward-looking ratio insurers report under the 80/20 rule, adjudged=TRUE — CMS published it); rebate-per-enrollee is a DERIVED sub-figure.

Source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year — https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio
Falsifier: A RECORD of measured/reported events (occurred=true) from CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year; superseded when CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year publishes its next release.

### What a Medical Loss Ratio is — and is NOT

**INTERPRETATION.** A Medical Loss Ratio is a spending ratio across an issuer's WHOLE book in a market for a past period — the share of premium spent on care + quality improvement versus administration and profit. It is NOT a measure of plan quality, of your individual plan's value, or of coverage availability, and it is NOT advice. A low MLR triggers a rebate; it does not rate care.

Source: Coverage Atlas L5 boundary (a book-level spending ratio ≠ plan quality) — https://coverage-atlas.ryanjhunter.workers.dev/
Falsifier: occurred=FALSE (a framing, not an event) and adjudged=FALSE (an in-house reading, not an authority's verdict) — the LOWEST-warrant claim here. A flat representation would render this identically to the official facts; the four-status does not.

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Every claim above carries a four-status warrant (RECORDED / MODELED / DERIVED / INTERPRETATION) and a named source you can re-fetch — this is a research object, not a flat fact. Structured: `https://coverage-atlas.ryanjhunter.workers.dev/coverage/mlr/77349-az.jsonld`

## Data

### Medical Loss Ratio by market — Banner Health and Aetna Health Insurance Company (Arizona, 2024)

CMS-published credibility-adjusted MLR, standard, premium, and rebate (RECORDED). Rebate-per-enrollee is DERIVED.

| Market | 3-yr MLR | Floor | Met floor? | Premium (2024) | Rebate owed | Per enrollee | Warrant |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Small group | 79.9% | 80% | no | $61,857,105 | $59,218 | ≈$6 | RECORDED |
| Large group | 87.1% | 85% | yes | $146,599,369 | $0 | — | RECORDED |