Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements under Patient Protection and Affordable Care Act

Docket ID: HHS-OS-2010-0026
Agency: Department of Health and Human Services (HHS)
The Affordable Care Act requires health insurance issuers offering individual or group coverage to submit annual reports to the Secretary on the percentages of premiums that the coverage spends on reimbursement for clinical services and activities that improve health care quality, and to provide rebates to enrollees if this spending does not meet minimum standards for a given plan year. This interim final rule would implement the definition and methodology associated with the calculation of the Medical Loss Ratio (MLR) provisions of the Affordable Care Act and the calculation of the rebate to consumers for plans that do not satisfy the MLR.
RIN: 0950-AA06
Impacts and Effects: None
CFR Citation: 45 CFR 158
Priority: Economically Significant
UA and Regulatory Plan Information open glossary dialog  
Publication Period: Spring 2011
Agenda Stage of Rulemaking: Completed Action
Major Rule: Yes
Legal Authorities: PL 111-148
Government Levels Affected: State
Federalism Implications: Yes
Unfunded Mandates: No
Requires Regulatory Flexibility Analysis: No
Small Entities Affected: No
International Impacts: No
Energy Effects: No
Included in Regulatory Plan: No
Legal Deadline
ActionDateFR Citation
Interim Final Rule12/01/201075 FR 74864
Interim Final Rule Comment Period End01/31/2011
Merged With 0938-AQ7102/11/2011
Docket Details open glossary dialog  
Related RINs: None
Related Dockets: None
Type: Rulemaking

Primary Documents

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Comment Period Closed
Jan 31, 2011 11:59 PM ET
Posted: 12/01/2010
ID: HHS-OS-2010-0026-0001

Supporting Documents

No documents available.


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Comments Received*
Regulatory Timeline
Pre Rule
Current Stage
Proposed Rule
Current Stage
Final Rule
Current Stage
Current Stage
Agency Contact
James Mayhew
Director, Division of Market Rules Compliance Office
Mail Stop C2-12016 7500 Security Boulevard
Baltimore, MD 21244
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