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Medical Loss Ratio (MLR)

a requirement that helps to make sure your monthly payments (premiums) go further in covering your health care. Health plans sold to individuals and small business employers must spend at least 80 cents of each premium dollar on health care and just 20 cents on administrative costs. Plans sold to large employers (generally more than 50 employees) must spend at least 85 cents of every premium dollar on health care and just 15 cents on administrative costs.

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