According
to CMS, in 2016 Connecticut for the first time since passage of the Affordable
Care Act (ACA), no insurers were required to provide rebates because they
exceeded the ACA’s Medical Loss Ratio (MLR) standards. The MLR provision of the
ACA required that insurers spend at least 80% of premiums for individual and
small group plans and 85% for large groups on medical care and quality
improvement. Insurers that do not meet the MLR standard must rebate that
portion of premiums to employers and consumers. In
2013 Connecticut insurers issued $3 million in MLR rebates on behalf of
69,186 state residents. Connecticut insurers have improved premium setting to
match medical and quality spending each year since then reducing rebates to $1.8
million in 2014 and $44,646
in 2015. Insurers in twelve states, including Connecticut, all met the MLR
standard in 2016, up from only six states the year before.
