Annual health insurance report

​​Percent of premium spent on medical care (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.

Percent of premium spent on medical care (medical loss ratio)
Insurer 2009 2010 2011 2012 2013 2014 2015​ 2016
Health Net 89% 81% 79% 83% 83% 90% ​95% 95%
Kaiser 96% 96% 95% 95% 97% 97% ​98% 98%
LifeWise 83% 83% 79% 81% 77% 89% ​104% 92%
Moda (ODS) 101% 93% 90% 87% 89% 93% ​100% 97%
PacificSource 84% 85% 85% 90% 87% 86% ​86% 91%
Providence 87% 82% 86% 84% 86% 89% ​95% 96%
Regence 87% 82% 86% 84% 86% 87% ​85% 84%
Overall average 91% 89% 89% 90% 91% 92% ​94% 94%

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.​​​​​​​​