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Blue Cross Blue Shield of Massachusetts Surpasses Medical Loss Ratio Requirements for 2015

The Patient Protection and Affordable Care Act requires insurers to meet specific medical loss ratio standards. This standard for large groups is 85 percent, which means that at least 85 percent of every premium dollar goes toward medical expenses, while the corresponding federal standard for small groups and individuals is 80 percent. In Massachusetts, however, the requirement for small groups and individuals (or merged market) is even higher-it is 88 percent.

Under Massachusetts law, if an insurer’s medical loss ratio is below the requirement, the company must issue rebates to the companies and people they insure. Blue Cross Blue Shield of Massachusetts will not be issuing rebates, as our loss ratio exceeded both state and federal medical loss ratio standards for all market segments subject to medical loss ratio regulations. We are proud to have surpassed the requirements by ensuring that more than ninety cents of every dollar goes toward paying medical expenses for our members.

Learn more about the medical loss ratio at www.HealthCare.gov or www.mass.gov.

Blue Cross Blue Shield of Massachusetts

Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association.
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