The medical loss ratio (MLR) is the percentage of premium that health insurers spend on medical care and quality improvement activities. These documents discuss the MLR and how it is used.
California's Medical Loss Ratio (MLR) Database, Findings, 2014 (593 K)
California's Medical Loss Ratio (MLR) Database, Findings, 2013 (551 K)
California's Medical Loss Ratio (MLR) Database, Findings, 2012 (764 K)
What Is the Medical Loss Ratio? (554 K)
How to Use the California Medical Loss Ratio Database (542 K)
Medical Loss Ratio Database, 2014 (2.05 MB)
Medical Loss Ratio Database, 2013 (1.38 MB)
Prior to the Affordable Care Act (ACA), many insurance companies were spending a substantial portion of premium dollars on overhead, such as administrative costs, sales expenses, and profits. Since 2011, the federal Department of Health and Human Services has enforced minimum MLR standards. The standards are intended to help consumers by:
A quick reference guide and two fact sheets about the MLR are available as Document Downloads.
California Health Insurers: Brink of Change
The Private Insurance Market in California, 2013