Tweet This
Medical Loss Ratio (MLR)
The percentage of health insurance premium dollars an insurer spends on reimbursement for clinical services and activities to improve health care quality. The Affordable Care Act sets minimum MLRs for different state markets; companies are required to issue rebates to consumers if too large a share of the expenditures are allocated to administrative costs not directly associated with care (maximum of 15 percent for large group plans and a maximum of 20 percent for individual or small group plans).