News & Updates
MLR applies to fully insured group commercial plans and individual plans. The law requires insurers to spend a minimum percentage of premium dollars (80 percent for individual and small group (1-50, or 1-100 depending on the market) markets and 85 percent for large group (51+ or 101+ depending on the market) on medical services and activities designed to improve health care quality. For 2016 rebate reporting year, the following 13 states define small group as 1 – 100 and large group as 101+: Alaska, Arkansas, California, Colorado, Florida, Louisiana, Nebraska, New York, Ohio, Tennessee, Texas, Utah and Wisconsin. The Year 6 calendar year began on Jan. 1, 2016.
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