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Medical Loss Ratio (MLR) Rebates and Employer Responsibilities

A medical loss ratio (MLR) is the amount of health insurance premiums that an insurer spends on health care and activities to improve health care quality. It is expressed as a percentage: for example, an MLR of 90% means 9 out of 10 of all premium dollars the insurer receives are spent on health care and quality improvement, with the other dollars spent on overhead, profits, and administrative costs.

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