MMO: 9/30/25 Broker Update

On September 30, 2025

Improved Life & Disability Census Template Launches October 1, 2025

Topic: Product News | Companies: MedMutual Life | Segment: Small Group (1-50), 51-99, 100+, MEWA

To improve onboarding efficiency for new groups with Life or Disability products, a revised Life & Disability Census Template will be launched on Oct. 1, 2025. Updates include simplified instructions, required field indicators and formatting protections to ensure data is entered correctly the first time for faster, smoother group installations.

Key Improvements

Instructions in the main tab and within the census headers have been clarified.
Required fields are now highlighted in yellow and will turn white once completed correctly, providing a visual cue for accuracy.
Fields are now programmed to accept only specific formats, and clicking on a field will display its formatting requirements. For example, date of birth will show “Cell Restriction MM/DD/YYYY”.
An Annual Enrollment tab has been added.
The rarely used Reinstate and Terminations tabs have been eliminated.

Life & Disability Census Submission Process

The revised Life & Disability Census Template has been posted to MyBrokerLink and should be used starting October 1, 2025. Beginning January 1, 2026, only the updated version will be accepted.

As a reminder, all census files for sold Life and Disability cases should be sent to your ExpressLink representative. If data is not in the proper format, the census will be returned for correction, potentially causing delays in installation.

Updates to the Small Group Product Portfolio for January 1, 2026 Renewals

Topic: Product News | Companies: Medical Mutual | Segment: Small Group (1-50), MEWA

Medical Mutual has updated the small group product portfolio to incorporate changes effective for renewals beginning Jan. 1, 2026. Plan changes and enhancements for the COSE Benefit Plan and 10-50 Balanced Solutions® product lines are laid out below. Groups will be informed of benefit changes during their scheduled renewal periods in 2026. Significant updates include:

COSE Benefit Plan Grid Flyers
- Copay
  - Three new plan options added: 30-6000 RX, 3020-5000 RX, 3020-7500 RX
  - Change to out-of-pocket maximum: 3020-6000 RX
  - HRA now included: 30-8000 RX, 30-6000 RX, 3020-7500 RX
- HSA
  - Two new plan options added: HSA 3500 (AGG) MMRX, HSA 5000 MMRX
  - Changes to out-of-pocket maximums: HSA 3500 PD RX, HSA 4000 PD RX, HSA 5000 PD RX
10-50 Balanced Solutions® Plan Grid Flyers
- Copay
  - Three new plan options added: 30-6000 RX, 3020-5000 RX, 3020-7500 RX
  - Change to out-of-pocket maximum: 3020-6000 RX
- HSA
  - Two new plan options added: HSA 3500 (AGG) MMRX, HSA 500 MMRX
  - Changes to out-of-pocket maximums: HSA 3500 PD RX, HSA 4000 PD RX, HSA 5000 PD RX
Addition of Telehealth with MinuteClinic®
- A flyer highlighting the new telehealth feature, which offers 24/7 telehealth services for a wide range of conditions, was developed for COSE Benefit Plan and 10-50 Balanced Solutions®.
- COSE Benefit Plan and 10-50 Balanced Solutions® copay plans now include access to MinuteClinic® at CVS as a preferred telehealth provider with a $0 cost. This addition is reflected in the revised plan grid flyers.
- COSE Benefit Plan and 10-50 Balanced Solutions® HSA plans now offer access to MinuteClinic® at CVS as a preferred telehealth provider, with all associated costs applied toward the deductible. This addition is reflected in the revised plan grid flyers.
CLE-Care and MedFlex Networks
- The CLE-Care and MedFlex networks are being phased out for COSE Benefit Plan and 10-50 Balanced Solutions® plan options. Going forward, all plans will utilize the Medical Mutual SuperMed® network and groups will migrate to the SuperMed® Plus product at their renewal.
Share Funding Arrangements
- Share plans were removed for COSE Benefit Plan options. Groups will map to their corresponding non-Share plan upon renewal.
Member Choice Pairings
- Specific Member Choice pairings are no longer included in COSE Benefit Plan options. Instead, groups can elect any plan combination of their choice.

COSE Benefit Plan Marketing Materials

The following materials have been updated to reflect these changes.

10-50 Balanced Solutions® Marketing Materials

The following materials have been updated to reflect these changes.

Medical Loss Ratio (MLR) Rebate Checks Issued to Medical Mutual Individual and Small Group Policyholders

Topic: Product News | Companies: Medical Mutual | Segment: Individual, Small Group (1-50)

The Affordable Care Act (ACA) includes a medical loss ratio provision. Medical loss ratio, or MLR, is the percentage of premium dollars an insurance company spends on medical services like claims and health and wellness programs.

The ACA requires health insurers to spend 85% of premiums received from large, fully insured employers (51+ employees) and 80% of premiums received from small, fully insured employers (1 to 50 employees) and individual product plans, toward medical expenses. The types of services that qualify as medical expenses include treatments, hospital admissions, doctor appointments, and programs to improve the quality of care our members receive. The remaining 20% or 15% we receive in premiums can be spent on administrative expenses like salaries, marketing and facility expenses.

By Sept. 30, 2025, health insurers not meeting the MLR criteria for fiscal year 2024 must pay rebates to impacted policyholders, both current and canceled (if they paid for coverage in 2024).

For fiscal year 2024, Medical Mutual is required to pay rebates to Medical Mutual individual policyholders and small groups of one policyholder who had coverage during 2024. We have mailed a letter to notify members. The rebate check has been mailed separately. Both were mailed to the policyholders in advance of the September 30, 2025, due date.

If you have any questions regarding this update from Medical Mutual, please reach out to your ExpressLink representative.