In the industry, so called medical loss ratios or MLRs will be required to stay above 85% for large group coverage and above 80 cents on the dollar of premium paid for small group and individual coverage.
New rules released this morning by Health Secretary Kathleen Sebelius say that HMOs must spend 80% (if they are for an individual) or 85% (for a group) of all premium dollars, net of taxes, on health care.