Final 2013 Medical Loss Ratio Report: Consumers Benefit From 80/20 Rule In 2013

In this report released July 24, 2014, the federal Department of Health and Human Services (HHS) announced that commercial individual and small group health plans would refund consumers $330 million in premium overpayments. Under the Patient Protection and Affordable Care Act of 2010 (PPACA), health plans must spend at least 80% of premiums on direct patient services and quality improvement activities; the percentage is called the medical loss ratio (MLR). Health plans that spend less must refund the difference between what they spent and 80% back to the individual or small group plan purchaser. About 6.8 million people were . . .