The Affordable Care Act ("ACA") uses the medical loss ratio as a financial measurement to encourage health plans to provide value to enrollees. Health insurance companies are now required to spend 80 to 85 percent of premium dollars on medical care and health care quality improvement, rather than on administrative costs The medical loss ratio measures this compliance and starting in 2012, insurers were required to provide a rebate to their customers if they failed to meet this standard. This continuing education class explains how to calculate the ratio and what it all means.

Class highlights include:

• Medical Loss Ratio Regulation and Calculation


• Insurer Reporting Requirements


• State flexibility and waivers


• Timing of Reporting and Rebates


• Activities That Improve Health Care Quality


• Credibility Adjustment for Small Plans


• Who Is Eligible for a Rebate?


• Savings in Addition to Rebates


• Approved for 2 Hours of Elective Continuing Education