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Minnesota’s Medical Loss Ratio


Medical Loss Ratio – The percentage of health insurance premiums that are spent by the insurance company on health care services. 

The Patient Protection and Affordable Care Act (ACA) requires that large group plans spend 85 percent of premiums on clinical services and other activities for the quality of care for enrollees. Small group and individual market plans must devote 80 percent of premiums to these purposes. 

Minnesota passed regulations in 1993 that initially required insurers in the small group market to meet a 75 percent medical loss ratio and individual market insurers to meet a 65 percent loss ratio. Both medical loss ratios increased by 1 percentage point each year until 2000, when the loss ratios were 82 percent in the small group market and 72 percent in the individual market. The loss ratios have remained at these levels since 2000 (See Minn. Stat. 62A.021).

Each year, the Minnesota Department of Commerce and the Minnesota Department of Health work collaboratively on an annual Medical Loss Ratio report. The most recent report can be found here:

Long Term Care and Medicare Reports


For future communications with regard to Long-Term Care and Medicare Supplement Reporting, the Minnesota Department of Commerce has established a special e-mail mailbox (HealthInsurance.Reports@state.mn.us).  Please include a brief cover e-mail, with the insurance company’s NAIC number and a clear subject line.  We recommend that you attach the documentation in PDF format.

If there are any questions concerning these requirements, please contact Melane Milbert at 651-539-1754 or at HealthInsurance.Reports@state.mn.us.

This request applies to the following reports:

Required by Minnesota Statutes, section 62S.25

  • Long-Term Care Insurance Claims Denial Report, due annually by June 30
  • Long-Term Care Insurance Replacement and Lapse Report, due annually by June 30
  • Long-Term Care Insurance Rescission Report, due annually by June 30
  • Long-Term Care Insurance Suitability Report, due annually by June 30

Required by Minnesota Statutes, section 62A.36

  • Medicare Supplement Calculation of Benchmark Ratio since Inception, due annually by May 31
  • Medicare Supplement Refund Calculation Form, due annually by May 31

Required by Minnesota Statutes, section 62A.319

  • Medicare Supplement Multiple Policy Report, due annually by March 1