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State insurance exchanges and Medical Loss Ratios
Who woulda thunk it? Did you know the state health insurance exchanges will be excluded from the new Federal MLR requirements? (Beginning not later than January 1, 2011, and subject to the definitions established through NAIC/HHS regulation, large‐group plans (101 employees or more) that spend less than 85% of premium revenue and small‐group (one to 100 employees) and individual plans that spend less than 80% of premium revenue on clinical services and activities to improve health care quality must provide a rebate to enrollees.)