Medical Loss Ratio

Florida Request for an Adjustment of the Medical Loss Ratio Standard

The Affordable Care Act allows the Secretary to adjust the Medical Loss Ratio (MLR) standard for a state if it is determined that meeting the 80 percent Medical Loss Ratio standard may destabilize the individual market. In order to qualify for this adjustment, a state must demonstrate that requiring insurers in its individual market to meet the 80 percent MLR has a likelihood of destabilizing the individual market and could result in fewer choices for consumers. This page contains materials related to this state’s application for an adjustment to the MLR standard for the individual market.

State: Florida

Application Status: HHS Determination Issued

Application Determination:

• HHS Determination on Florida MLR Adjustment Request (PDF)  (PDF - 164 KB)
• Fact Sheet (Posted on December 15, 2011)
• HHS Determination on Florida’s Request for Reconsideration (PDF) (PDF - 63 KB)

Application Materials: Additional materials, including all information submitted by the State, correspondence from HHS, and any public comments, are available upon request.  Please email MLRQuestions@cms.hhs.gov.