Everything you need to know about health insurance
Tuesday, August 24th, 2010
What is Medical Loss Ratio (MLR)?
Note: None of this should be taken as legal or tax advice.
A medical loss ratio (MLR) is the percentage of insurance premium dollars spent on health care claims.
Beginning on January 1, 2011, insurance companies will be required to report the proportion of premium dollars spent on clinical services and other costs. If an insurer does not meet the minimum medical loss ratio, the company will be forced to refund the difference to policyholders.
For large group plans, the minimum medical loss ratio is 85%. For small group and individual plans, the minimum medical loss ratio is 80%.
Clarifying Health is a blog about health insurance, health benefits, and everything else related to how Americans pay for medical expenses.
If you have any tips or suggestions for this blog, send an email to blog@ZaneBenefits.com and let us know. We always appreciate feedback
We also run a company called Zane Benefits where we're doing everything we can to help America out of the current healthcare mess.
If you want to learn more about how Zane Benefits helps companies with their benefits, or you're interested in working with us, visit the Zane Benefits website.
