Skip to Main Content
 

The Center for Consumer Information & Insurance Oversight

 

Medical Loss Ratio Data and System Resources

The Affordable Care Act requires health insurance companies to disclose how much they spend on health care and how much they spend on administrative costs, such as salaries and marketing. If an insurance company spends less than 80% (85% in the large group market) of premium on medical care and efforts to improve the quality of care, they must rebate the portion of premium that exceeded this limit. This rule is commonly known as the 80/20 rule or the Medical Loss Ratio (MLR) rule.

Search Tool

2011 Reporting Year

2012 Reporting Year