Q:

What is Horizon Blue MLR?

A:

Quick Answer

Horizon Blue MLR refers to the federal medical loss ratio requirement that health insurance companies must meet to comply with the Affordable Care Act. Horizon Blue must provide rebates to its consumers if a certain amount of the premiums are not spent on health-related costs, says Horizon.

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Full Answer

The percentage of premiums that Horizon Blue must spend on health care services is at least 80 percent of the amount it collects from small employer groups and individual members and at least 85 percent of the premiums it collects from large employer groups. This means that Horizon can only spend about 15 to 20 percent of the money it collects on salaries, marketing and sales, according to Horizon.

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