Tagged: MLR

Beginning in 2011, the law requires insurance companies in the individual and small group markets to spend at least 80 percent of the premium dollars they collect on medical care and quality improvement activities. Insurance companies in the large group market must spend at least 85 percent of premium dollars on medical care and quality improvement activities. Insurance companies must report their MLR data to HHS on an annual basis so that residents of every State will have information on the value of health plans offered by different insurance companies in their State. Insurance companies that do not meet the MLR standard will be required to provide rebates to their consumers. Insurers made the first round of rebates to consumers in 2012. Originally, rebates were required to be paid by August 1st each year, but this date has since been pushed back. Source: CMS Fact Sheet “Medical Loss Ratio: Getting Your Money’s Worth on Health Insurance”