Medical Loss in the United States

Concept of Medical Loss Ratio in Health Insurance Law

In this context, the following is a definition of Medical Loss Ratio: The percentage of health insurance premiums that are spent by the insurance company on health care services. PPACA requires that large group plans spend 85% of premiums on clinical services and other activities for the quality of care for enrollees. Small group and individual market plans must devote 80% of premiums to these purposes.