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(medical loss ratio)
The medical loss ratio is the percentage of health insurance premiums that an insurer pays in health care claims, including amounts reserved for expected future payments for services already provided and for claims the insurer expects to be reported. For example, an insurer with a 90 percent medical loss ratio pays 90 cents in claims costs for every dollar collected in premiums.
Source: Annual or quarterly financial statements filed with the National Association of Insurance Commissioners or the Oregon Division of Financial Regulation.
Note: Calculations for medical loss ratio are different than those required by the federal government and cannot be used to determine if an insurance company owes a rebate.
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