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What is Medical Loss Ratio (MLR)?

Written by: PeopleKeep Team
August 24, 2010 at 1:02 AM

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%.

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Topics: Health Insurance Carriers

Additional Resources

Trying to decide which HRA is best for you? Take our quiz to find out.
Get our guide on how to offer health benefits with a small budget.

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