June 13, 2014
Blue Cross and Blue Shield of Illinois (BCBSIL) met or exceeded the medical loss ratio (MLR) standards for all eligible Illinois members for 2013. BCBSIL is a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), which operates divisions in Illinois, Montana, New Mexico, Oklahoma, and Texas. All these market segments as well as student health will not receive a rebate for the 2013 MLR reporting year.
We are proud of our track record of offering insurance products and services to all segments of the market including small group and individual policies. We are pleased with our strong expense management, business innovations, and our collaboration with providers and other health care professionals, in order to meet the MLR reporting standards.
MLR is the percentage of insurance premium dollars that an insurance company spends on reimbursement for clinical services or medical expenses and improvements to health care quality.
The Affordable Care Act (ACA) sets medical loss ratio standards for different markets, as do some state laws. Insurance companies may have to issue rebates to members if their MLR does not meet or exceed the MLR standard for the particular market of a state.
The MLR standard for the large group market is 85% and the MLR standards for small group and individual markets are 80%.
HCSC is a customer-owned organization that reinvests its earnings to benefit the health and wellness of its customers. It does not distribute its profits to outside investors.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
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