The loss ratio is 1.67, or 167%; therefore, the company is in poor financial health and unprofitable because it is paying more in claims than it receives in revenues.

Insurers estimate they will issue about $1.1 billion in medical loss ratio (MLR) rebates across all commercial markets in 2023, according to a new report from KFF.

Simple loss ratios are calculated as the ratio of the sum of total incurred claims to the sum of health premiums earned. Rebates for 2024 are based on preliminary estimates from insurers.

The authors used medical loss ratio forms to assess trends in premiums, medical claims, administrative costs, quality improvement, and margins in the large group insurer market.

The medical loss ratio should be redefined so spending on social drivers of health is seen as preventive care, not administrative costs. Skip to Main Content. Congress. dementia. neurology.

The loss ratio is 1.67, or 167%; therefore, the company is in poor financial health and unprofitable because it is paying more in claims than it receives in revenues.