The MLR, part of the Patient Protection and Affordable Care Act, requires insurers to spend at least 80 percent of health premiums for individual and small group markets, or 85 percent for large group markets, on medical care by 2014. The remaining 15 or 20 percent of costs can be used toward administrative costs and profit.
Texas asked HHS for a 74 percent MLR this year and a 77 percent MLR in 2013.
HHS has now rejected MLR adjustments in nine states and has approved MLR adjustments in six states.
Related Articles on the Medical Loss Ratio:
HHS Denies Medical Loss Ratio Adjustments for Kansas, Oklahoma
How Will ICD-10 Costs Be Affected by the Medical Loss Ratio Rule?
Final Regulations on Medical Loss Ratio Issued
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