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.

The law specifically charged the NAIC with creating the definitions and methodologies for implementing this requirement, subject to certification by the Department of Health and Human Services (HHS).

Want to continue reading?
Become a Free
PropertyCasualty360 Digital Reader.


  • All news coverage, best practices, and in-depth analysis.
  • Educational webcasts, resources from industry leaders, and informative newsletters.
  • Other award-winning websites including and

Already have an account?


Complex Claims & Litigation Forum 2023Event

Aimed to help Insurers prevent, prepare and prevail In adjudicating complex claims, negotiating settlements and winning cases.

Get More Information


Join PropertyCasualty360

Don’t miss crucial news and insights you need to make informed decisions for your P&C insurance business. Join now!

  • Unlimited access to - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including, and
  • Exclusive discounts on PropertyCasualty360, National Underwriter, Claims and ALM events

Already have an account? Sign In Now
Join PropertyCasualty360

Copyright © 2022 ALM Global, LLC. All Rights Reserved.