What Is A Medical Loss Ratio
Health plans that spend too much on administrative costs—and thus fail to meet the MLR requirements—must send rebates to plan members (or to the federal government, in the case of Medicare Advantage plans). Health insurance is also regulated at the state level. States can set minimum MRL requirements for Medicaid managed care plans, and they can impose MLR requirements for individual/family and group health plans that are stricter than the federal requirements....