Medical Loss Ratio (MLR) Rebate Deadline Approaching

As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. The MLR threshold for large groups is 85%, and the threshold for small group and individual policies is 80%. The MLR ratio is based on the insurer’s block of business in the state, and not on the specific policy’s claims experience and administrative costs.


Fairmount Benefits Company

Two Radnor Corporate Center
Suite 110
Radnor, PA 19087

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