Medical Loss Ratio · New Jersey · 2024 reporting year · CVS Health Group
Aetna Health Inc. (a New Jersey corporation)
In New Jersey, over the three-year window through 2024, Aetna Health Inc. (a New Jersey corporation) spent 81.4% of large group premiums on care (its Medical Loss Ratio). Because that fell below the floor in one market, it must rebate the shortfall to its 2024 policyholders — $793,414 in all.
Where each premium dollar went
The filled bar is the share of premiums spent on medical care + quality improvement — the three-year Medical Loss Ratio. The marker is the legal floor for that market (80% individual & small group, 85% large group). Below the floor, the insurer rebates the shortfall (floor − MLR), applied to that year's premium.
See what Aetna Health Inc. (a New Jersey corporation)sells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all New Jersey marketplace plans. Complaint counts and loss ratios for Aetna Health Inc. (a New Jersey corporation) (NAIC 95287) are on its carrier quality profile.
RECORDED — the Medical Loss Ratio, the 80/85% standard, premium earned, and the rebate owed are CMS-published figures (the 2024 MLR reporting year, a three-year window through 2024; rebates are paid the following year). DERIVED — rebate as a share of premium, and the rebate per enrollee (rebate ÷ member-years).
Machine-readable: JSON-LD · Markdown · Source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year
What this is — and is not
This is how Aetna Health Inc. (a New Jersey corporation) spent premium dollars across its entire New Jersey book in each market — it is not a measure of a specific plan's quality, your denial odds, or whether the insurer is right for you, and it is not advice. A rebate, if owed, is a rule-based payment to policyholders (a check or premium credit) the following year. To compare plans, check eligibility, and enroll, go to HealthCare.gov.