Medical Loss Ratio Search Tool

About the Search tool

Use the search tool to find commercial Medical Loss Ratio reports for health insurance companies offering coverage in the individual, small group, or large group market. To get started, select a reporting year and click the Search button. You may also select one or more states/territories, or enter a company name.

The search tool only lists results for insurers that have submitted an MLR report.

Year

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State/Territory

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Enter a partial or complete company name

Search Results

The ZIP files include data for every state that the company reported in. The states/territories you search for are included in each zip file.

About the Medical Loss Ratio

The Affordable Care Act requires health insurance issuers to submit data on the proportion of premium revenues spent on clinical services and quality improvement, also known as the Medical Loss Ratio (MLR). It also requires them to issue rebates to enrollees if this percentage does not meet minimum standards. MLR requires insurance companies to spend at least 80% or 85% of premium dollars on medical care, with the review provisions imposing tighter limits on health insurance rate increases. If they fail to meet these standards, the insurance companies are required to provide a rebate to their customers starting in 2012.

Update: Insurers must submit a report each year to the Department of Health and Human Services (HHS) showing how much the insurer spent on health care and activities that improve care in the past year. Each year's report is due by July 31 of the following year. For example, an insurer must submit its yearly report for 2016 by July 31, 2017.

Each insurer’s Medical Loss Ratio information is provided separately for each state and, within each state, by market (individual, small group and large group markets). It is not provided by a particular plan, product, or policy.

Page Last Modified:
09/07/2023 09:06 AM