The Medical Loss Ratio (MLR) final rules require insurance carriers in the small group and individual markets to spend at least 80% of the premiums toward the participants medical expenses. Insurance carriers insuring large groups must spend a minimum of 85% of the premium on medical expenses. Insurance companies that do not meet the minimum requirement must rebate the consumers a portion of the premium.
The first round of rebates will begin this year for carriers not meeting the requirements in 2011.
All rebates must be distributed before August 1st, 2012.