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AB 2499: Health care coverage: medical loss ratios (2017 - 2018)


Current law requires a health care service plan or health insurer that issues, sells, renews, or offers a health care service plan contract or health insurance policy, respectively, for health care coverage in this state to comply with minimum medical loss ratios, and to provide an annual rebate to each enrollee or insured under that coverage, on a pro rata basis, if the medical loss ratio of the amount of premium revenue expended by the plan or health insurer on the costs for reimbursement for clinical services and for activities that improve health care quality to the total amount of premium revenue is less than a certain percentage. This bill would increase the minimum medical loss ratio percentages applicable to health care service plans and health insurers by 5%, except as specified.

Health Access
Protecting Health Care Reform
CPEHN Position: 
Approved by the Governor. Chaptered by Secretary of State