The Affordable Care Act includes features that promote transparency and hold insurers accountable for how they spend your premium dollars and rate increases. “Medical Loss Ratio” and “Rate Review” are two features of the health care law that are in place and making a difference for consumers.
- Medical Loss Ratio: Insurers must, in general, spend 80% or 85% of the premium dollars they take in on health care costs and health care improvement activities. If they do not, they must provide refunds to policy holders.
- Rate Review: Health insurance companies must tell consumers when they want to increase insurance rates for individual or small group policies by an average of 10% or more. Learn more about Rate Reviews.
Healthcare.gov has created a search tool to find a basic profile of your insurance company or information about Medical Loss Ratio (MLR) and Rate Reviews. Medical Loss Ratio (MLR) and Rate Reviews Carrier Profiles