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Medical Loss Ratios (MLRs)
The ACA’s medical loss ratio (MLR) rules require health insurance issuers to spend 80 to 85 percent of their premium dollars on medical care and health care quality improvement activities. Issuers that do not meet the applicable MLR (medical loss ratio) standard must pay rebates to consumers. The next round of rebates is due by Sept. 30, 2020. This Benefits Brief provides a summary of the MLR rules and explains how employers should treat any rebates received for group health plans.