Fierce Healthcare September 10, 2019
Insurers are projected to pay out a record high $1.3 billion in medical loss ratio (MLR) rebates in 2019, according to a new analysis from the Kaiser Family Foundation.
The MLR requirement was established under the Affordable Care Act and is designed to limit the amount of premium dollars insurers can apply toward administrative costs, marketing and profit. For individual and small group plans, 80% of the money brought in through premiums must be applied to medical costs, and that increases to 85% for large group plans.
MLR rebates are calculated using a three-year average. So 2019 figures are based on data from 2016, 2017 and 2018, according to the report.
Insurers have the option of paying rebates in...
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