Section 2718: Medical Loss Ratio
GPTKB entity
Statements (19)
| Predicate | Object |
|---|---|
| gptkbp:instanceOf |
gptkb:United_States_federal_law
|
| gptkbp:appliesTo |
individual market
large group market small group market |
| gptkbp:codifiedIn |
gptkb:42_U.S.C._§_300gg-18
|
| gptkbp:dateEnacted |
2010
|
| gptkbp:enforcedBy |
gptkb:U.S._Department_of_Health_and_Human_Services
|
| gptkbp:excludes |
self-insured plans
|
| gptkbp:goal |
limit insurer administrative costs and profits
|
| https://www.w3.org/2000/01/rdf-schema#label |
Section 2718: Medical Loss Ratio
|
| gptkbp:minimumMLRIndividualSmallGroup |
80%
|
| gptkbp:minimumMLRLargeGroup |
85%
|
| gptkbp:partOf |
gptkb:Patient_Protection_and_Affordable_Care_Act
|
| gptkbp:regulates |
health insurance issuers
|
| gptkbp:requires |
minimum percentage of premium revenue spent on clinical services and quality improvement
|
| gptkbp:requiresRebate |
if insurer fails to meet MLR standard
|
| gptkbp:requiresReporting |
insurer spending on claims, quality improvement, and administrative costs
|
| gptkbp:bfsParent |
gptkb:Public_Health_Service_Act
|
| gptkbp:bfsLayer |
6
|