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Minimum Medical Loss Ratio for Insurers

Ratio of insurance expenditures used on care as opposed to administrative or other costs. Under ACA insurance companies are required to issue rebates to consumers if too large a share of the expenditures are allocated to costs not directly associated with care (max of 15% for large group plans, max of 20% for individual or small group plans).

Out-of-Pocket Maximum

A cap on the amount of money per year that individuals might pay for health care costs, excluding the premium cost. All costs above the…