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For months, a National Association of Insurance Commissioners working group has been busily drafting regulations to implement a key provision of the health law — its medical loss ratio requirement. This provision requires insurers in the individual and small group market to spend at least a minimum proportion of their premium revenues on health care services and activities that improve health care quality. Beginning in 2011, insurers who fail to meet these targets must rebate to enrollees the difference between their actual expenditures and the target amount.

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